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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 ...
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]
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]
Troponin T (blue) anchors the complex on tropomyosin. Troponin is found in both skeletal muscle and cardiac muscle, but the specific versions of troponin differ between types of muscle. The main difference is that the TnC subunit of troponin in skeletal muscle has four calcium ion-binding sites, whereas in cardiac muscle there are only three.
Troponin T binds to tropomyosin and helps position it on actin, [2] and together with the rest of the troponin complex, modulates contraction of striated muscle. [3] The cardiac subtype of troponin T is especially useful in the laboratory diagnosis of heart attack because it is released into the blood-stream when damage to heart muscle occurs. [4]
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Troponin I, fast skeletal muscle is a protein that in humans is encoded by the TNNI2 gene. [5] [6]The TNNI2 gene is located at 11p15.5 in the human chromosomal genome, encoding the fast twitch skeletal muscle troponin I (fsTnI). fsTnI is a 21.3 kDa protein consisting of 182 amino acids including the first methionine with an isoelectric point (pI) of 8.74.
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] One high-sensitivity cardiac troponin can rule out a heart attack as long as the ECG is normal. [83] [84]