Cardiac troponin I in the diagnosis of myocardial injury and infarction

Mair,J.; Genser,N.; Morandell,D.; Maier,J.; Mair,P.; Lechleitner,P.; Calzolari,C.; Larue,C.; Ambach,E.; Dienstl,F.; Pau,B.; Puschendorf,B.
We used a cardiospecific enzymoimmunometric assay to measure cardiac troponin I (cTnI) in samples serially drawn from 78 patients with acute myocardial infarction (AMI), 7 patients with unstable angina (Braunwald class III), 22 multi-traumatized patients, and in 30 athletes after eccentric exercise, as well as in 101 non-traumatic chest pain patients on admission to the emergency department. cTnI assay crossreactivity with crude human skeletal muscle homogenates was < 0.1%. cTnI could not be detected in athletes or multi-traumatized patients except for 2 trauma patients with myocardial damage. Increased cTnI concentrations were found in 6 of 7 patients with unstable angina at rest and in all AMI patients. After AMI, cTnI increased about 3.5 h (median) after the onset of chest pain, reached peak values parallel to CKMB, and stayed increased for at least 4 days. Cardiac troponin T (cTnT) increased and mostly peaked parallel to cTnI. cTnT sensitivity on the 7th day after AMI was significantly higher than that of cTnI. In contrast to cTnI, cTnT mostly showed a second, usually smaller, peak about day 4 after AMI. During the first 4 h after the onset of chest pain and before thrombolytic therapy the sensitivities of myoglobin (0.43) and CKMB mass (0.56) were significantly higher than those of both troponins (cTnI, 0.29; cTnT, 0.25). Areas under receiver operator characteristic curves indicated only moderate diagnostic accuracies of bio-chemical markers for early AMI diagnosis in non-traumatic chest pain patients that cTnI is a highly sensitive and specific marker for myocardial damage which is suitable for early and late diagnosis
Clin Chim.Acta 1996 245(1):19-38
Tags: 96233850; adult; aged; blood; chemistry; diagnosis; diagnostic use; drug therapy; exercise; female; Heart Injuries; human; injuries; male; markers; metabolism; middle age; Myocardial Infarction; Myocardium; physiopathology; Sensitivity and Specificity; therapy; Thrombolytic Therapy; Troponin
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