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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]
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]
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]
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]
Troponin levels increase in 35-50% of people with pericarditis. [ 8 ] Electrocardiogram (ECG) changes in acute pericarditis mainly indicates inflammation of the epicardium (the layer directly surrounding the heart), since the fibrous pericardium is electrically inert.
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.