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The 99th percentile cutoff for cardiac troponin T (cTnT) is 0.01 ng/mL. [5] The reference range for the high sensitivity troponin T is a normal < 14 ng/L, borderline of 14-52 ng/L, and elevated of >52 ng/L. [6]
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]
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.
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.
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 muscle troponin T (cTnT) is a protein that in humans is encoded by the TNNT2 gene. [ 5 ] [ 6 ] Cardiac TnT is the tropomyosin -binding subunit of the troponin complex, which is located on the thin filament of striated muscles and regulates muscle contraction in response to alterations in intracellular calcium ion concentration.
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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]