Cardiac Troponin I or T for the Diagnosis of Myocardial Infarction and Prediction of Outcomes—Does It Matter?
Year: 2024
Type: article
Abstract: Immunoassays measuring the I and T subunits of the cardiac troponin complex are widely used for the diagnosis of myocardial infarction (1). International guidelines recommend high-sensitivity assays measuring either cardiac troponin I or T (1), based on evidence suggesting that they have comparable diagnostic performance (2). In contrast, recent studies have suggested that these markers may differ in their ability to predict adverse outcomes (3). While cardiac troponin T seems a better predictor for all-cause death, cardiac troponin I may be superior in predicting cardiovascular events (3). One of the challenges comparing the performance of cardiac troponin assays is that different measurands are involved with troponin I and T, and there is no standardization between cardiac troponin I assays. As such, the 99th percentile upper reference limits (URLs) used for the diagnosis of myocardial infarction are derived from different healthy reference populations and are not equivalent (4–8). Consequently, it is unclear whether variation in the proportion of patients identified with myocardial injury is due to differences in the pathobiology of cardiac troponin release and clearance, or assay characteristics and differences in the URL. Moreover, several factors, such as age, sex, and kidney disease, influence cardiac troponin concentrations, but their impact on the diagnostic and prognostic performance of cardiac troponin I and T assays is incompletely understood.
Source: Clinical Chemistry
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: National Science Foundation, Abbott Laboratories, Universität Basel, Universitätsspital Basel, British Heart Foundation, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Gottfried und Julia Bangerter-Rhyner-Stiftung, Schweizerische Akademie der Medizinischen Wissenschaften, Siemens Healthineers
OpenAlex ID: W4401894991