Cardiac Troponin T in Diagnosis of Acute Myocardial Infarction

Authors: Gülinnaz ALPER, Ömür ERKIZAN, Can HASDEMİR, Azem AKILLI, Taner ONAT

Abstract: Cardiac Troponin T (TnT) is a regulatory contractile protein not normally found in blood. Its detection in the circulation has been shown to be a sensitive and specific marker for myocardial cell damage. This study was designed to evaluate the diagnostic efficiency of TnT enzyme immunoassay for the early diagnosis of AMI (Acute Myocardial Infarction) and to compare this newly developed test with the conventionally used cardiac enzyme tests in need of an alternative test of greater sensitivity and specificity. The study population consisted of 13 patients with a mean age of 52±8 years who were hospitalized for AMI. Blood samples for TnT, CPK and CK-MB measurements were drawn at the time of admission (2.9±1.7 hours after the onset of chest pain) and at the 4th, 14-16 th , 32-34 th and 100-130 th hours thereafter. We used an enzyme immunologic assay for the quantitative determination of serum TnT and enzymatic methods for CPK and CK-MB. TnT appeared in circulation slightly earlier than CPK and CK-MB and increased to a peak value of 46 times the detection limit during the first day. Relative peak values of TnT after onset of pain were 6.4 and 6.8 fold higher than CK-MB and CPK results. The sensitivity of TnT for detecting AMI was 100% from the 4 th hour to the 100-130 th hour after the onset of symptoms and the diagnostic sensitivity of TnT was superior to that of CPK and CK-MB (100% versus 23% and 15%). Thus the results of this study indicate that; TnT test improves the efficiency of serodiagnostic tools in detection of AMI and gives a larger diagnostic window that allows serological detection of subacute myocardial infarction.

Keywords: troponin T, acute myocardial infarction

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