Troponin T vs troponin I in the diagnosis of myocardial infarction

P. Vijay, T. G. Sharp, John Brown

Research output: Contribution to journalArticle

Abstract

Recent advances in technology has made it possible to use proteins other than the "gold standard" creatine kinase MB fraction, such as troponin-T (Tn-T), and troponin-I (Tn-I) that are cardiospecific for the detection of minor myocardial damage. We compared blood Tn-T, Tn-I levels and the hemodynamics of the patients undergoing cardiopulmonary bypass surgery (CPB). Thirty five patients who underwent open heart surgery using CPB were included in this study. Blood Tn-T and Tn-I levels were measured by immunoassays. Based on their 12 hour Tn-T levels, the patients were divided into groups, A: Tn-T<5 (n=24), B:>5 (n=6), C:>10(n=5). Tn-T and Tn-I levels were compared with the hemodynamic data within the group. When 12 hour levels of Tn-T and Tn-I were compared in groups A and B, the levels correlated with the extent of myocardial damage. Group C had patients with known myocardial damage (atrial fibrillation-1, acute MI-2, cardiogenic shock-1). The 12 hour Tn-T and Tn-I levels are shown in the table along with the hemodynamic support data. Group C patients had more use of ventilator and inotropic supports. Group Tn-T (ng/ml) Tn-I (ng/ml) Vent.use IABP lno.Supp pre-op 12 h pre-op 12 h hrs hrs hrs A 0.6±0.2 2.7±0.6 0.4±0.2 4.6±1 15±6.7 0 12±9 B 1.0±0.2 6.7±0.8 1.1±0.4 8.5±3 32±8.0 0 16±8 C 14.2±3 41±11 3.5±1.0 28±10 85±20 14 134±40 Our results, from a small group of patients, clearly indicate that Tn-T predicts the extent of myocardial injury preoperatively more accurately, and in most cases, Tn-T and Tn-I measurements are specific and sensitive enough to determine the myocardial injury perioperatively. But high Tn-I seen in some patients perioperatively that are not supported by the need for hemodynamic support is of great concern.

Original languageEnglish
JournalJournal of Investigative Medicine
Volume47
Issue number2
StatePublished - Feb 1999

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Troponin T
Troponin I
Myocardial Infarction
Hemodynamics
Surgery
Cardiopulmonary Bypass
Blood
MB Form Creatine Kinase
Cardiogenic Shock
Vents
Wounds and Injuries
Mechanical Ventilators
Immunoassay
Atrial Fibrillation
Thoracic Surgery
Technology

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Troponin T vs troponin I in the diagnosis of myocardial infarction. / Vijay, P.; Sharp, T. G.; Brown, John.

In: Journal of Investigative Medicine, Vol. 47, No. 2, 02.1999.

Research output: Contribution to journalArticle

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abstract = "Recent advances in technology has made it possible to use proteins other than the {"}gold standard{"} creatine kinase MB fraction, such as troponin-T (Tn-T), and troponin-I (Tn-I) that are cardiospecific for the detection of minor myocardial damage. We compared blood Tn-T, Tn-I levels and the hemodynamics of the patients undergoing cardiopulmonary bypass surgery (CPB). Thirty five patients who underwent open heart surgery using CPB were included in this study. Blood Tn-T and Tn-I levels were measured by immunoassays. Based on their 12 hour Tn-T levels, the patients were divided into groups, A: Tn-T<5 (n=24), B:>5 (n=6), C:>10(n=5). Tn-T and Tn-I levels were compared with the hemodynamic data within the group. When 12 hour levels of Tn-T and Tn-I were compared in groups A and B, the levels correlated with the extent of myocardial damage. Group C had patients with known myocardial damage (atrial fibrillation-1, acute MI-2, cardiogenic shock-1). The 12 hour Tn-T and Tn-I levels are shown in the table along with the hemodynamic support data. Group C patients had more use of ventilator and inotropic supports. Group Tn-T (ng/ml) Tn-I (ng/ml) Vent.use IABP lno.Supp pre-op 12 h pre-op 12 h hrs hrs hrs A 0.6±0.2 2.7±0.6 0.4±0.2 4.6±1 15±6.7 0 12±9 B 1.0±0.2 6.7±0.8 1.1±0.4 8.5±3 32±8.0 0 16±8 C 14.2±3 41±11 3.5±1.0 28±10 85±20 14 134±40 Our results, from a small group of patients, clearly indicate that Tn-T predicts the extent of myocardial injury preoperatively more accurately, and in most cases, Tn-T and Tn-I measurements are specific and sensitive enough to determine the myocardial injury perioperatively. But high Tn-I seen in some patients perioperatively that are not supported by the need for hemodynamic support is of great concern.",
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N2 - Recent advances in technology has made it possible to use proteins other than the "gold standard" creatine kinase MB fraction, such as troponin-T (Tn-T), and troponin-I (Tn-I) that are cardiospecific for the detection of minor myocardial damage. We compared blood Tn-T, Tn-I levels and the hemodynamics of the patients undergoing cardiopulmonary bypass surgery (CPB). Thirty five patients who underwent open heart surgery using CPB were included in this study. Blood Tn-T and Tn-I levels were measured by immunoassays. Based on their 12 hour Tn-T levels, the patients were divided into groups, A: Tn-T<5 (n=24), B:>5 (n=6), C:>10(n=5). Tn-T and Tn-I levels were compared with the hemodynamic data within the group. When 12 hour levels of Tn-T and Tn-I were compared in groups A and B, the levels correlated with the extent of myocardial damage. Group C had patients with known myocardial damage (atrial fibrillation-1, acute MI-2, cardiogenic shock-1). The 12 hour Tn-T and Tn-I levels are shown in the table along with the hemodynamic support data. Group C patients had more use of ventilator and inotropic supports. Group Tn-T (ng/ml) Tn-I (ng/ml) Vent.use IABP lno.Supp pre-op 12 h pre-op 12 h hrs hrs hrs A 0.6±0.2 2.7±0.6 0.4±0.2 4.6±1 15±6.7 0 12±9 B 1.0±0.2 6.7±0.8 1.1±0.4 8.5±3 32±8.0 0 16±8 C 14.2±3 41±11 3.5±1.0 28±10 85±20 14 134±40 Our results, from a small group of patients, clearly indicate that Tn-T predicts the extent of myocardial injury preoperatively more accurately, and in most cases, Tn-T and Tn-I measurements are specific and sensitive enough to determine the myocardial injury perioperatively. But high Tn-I seen in some patients perioperatively that are not supported by the need for hemodynamic support is of great concern.

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