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Troponin I is a biomarker that responds to treatment interventions. Reductions in troponin I levels proved to reduce the risk of future CVD. [23] [24] [25] High sensitive troponin I used as a screening tool to assess a person's cardiovascular risk and has the potential to reduce the growing cost burden of the healthcare system. [26]
Test Sensitivity and specificity Approximate peak Description Troponin test: The most sensitive and specific test for myocardial damage. Because it has increased specificity compared with CK-MB, troponin is composed of 3 proteins- Troponin C, Cardic troponin I, and Cardiac troponin T. Troponin I especially has a high affinity for myocardial injury.
Strenuous endurance exercise such as marathons or triathlons can lead to increased troponin levels in up to one-third of subjects, but it is not linked to adverse health effects in these competitors. [27] [28] [29] High troponin T levels have also been reported in patients with inflammatory muscle diseases such as polymyositis or dermatomyositis.
Cardiac troponin T (low sensitive) 0.1 [7] ng/mL: 99th percentile cutoff: Cardiac troponin I (high sensitive) 0.03 [7] ng/mL 99th percentile cutoff: Cardiac troponin T (high sensitive) Male 0.022 [7] ng/mL 99th percentile cutoff: Female 0.014 [7] ng/mL 99th percentile cutoff: newborn/infants not established more than adults [60] [61]
Ca 2+ binds to a protein called troponin, which is bound to the actin filament. This binding causes a shape change in the troponin which exposes areas on the actin, to which the head of the myosin filament binds. The binding of the myosin head to actin is known as a cross-bridge.
Troponin I, cardiac muscle is a protein that in humans is encoded by the TNNI3 gene. [ 5 ] [ 6 ] It is a tissue-specific subtype of troponin I , which in turn is a part of the troponin complex . The TNNI3 gene encoding cardiac troponin I (cTnI) is located at 19q13.4 in the human chromosomal genome.
It should be considered in all patients with acute pericarditis, preferably in combination with a short-course of NSAIDs. [10] For patients with a first episode of acute idiopathic or viral pericarditis, they should be treated with an NSAID plus colchicine 1–2 mg on first day followed by 0.5 daily or twice daily for three months.
A rise in troponin occurs within 2–3 hours of injury to the heart muscle, and peaks within 1–2 days. The level of the troponin, as well as a change over time, are useful in measuring and diagnosing or excluding myocardial infarctions, and the diagnostic accuracy of troponin testing is improving over time. [72]