Biomarkers

What is Troponin?

Troponin proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. The more damage there is to the heart, the greater the amount of troponin T and I there will be in the blood.

  • The most common reason to perform this test is to see if a heart attack has occurred.
  • The troponin test may also be done to help detect and evaluate other causes of heart injury.
  • The test may be done along with other cardiac marker tests, such as CPK isoenzymes or myoglobin.

Normal Results:

Cardiac troponin levels are normally so low they cannot be detected with most blood tests. Having normal troponin levels 12 hours after chest pain has started means a heart attack is unlikely.

A normal value range may vary slightly among different laboratories. Some labs use different measurements (for example, “high sensitivity troponin test”) or test different samples. Also, some labs have different cutoff points for “normal” and “probable myocardial infarction.” Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean:

Even a slight increase in the troponin level will often mean there has been some damage to the heart. Very high levels of troponin are a sign that a heart attack has occurred.

Most patients who have had a heart attack have increased troponin levels within 6 hours. After 12 hours, almost everyone who has had a heart attack will have raised levels.

Troponin levels may remain high for 1 to 2 weeks after a heart attack.

Increased troponin levels may also be due to:

  • Abnormally fast heartbeat
  • High blood pressure in lung arteries (pulmonary hypertension)
  • Blockage of a lung artery by a blood clot, fat, or tumor cells (pulmonary embolus)
  • Congestive heart failure
  • Coronary artery spasm
  • Inflammation of the heart muscle usually due to a virus (myocarditis)
  • Prolonged exercise (for example, due to marathons or triathlons)
  • Trauma that injures the heart, such as a car accident
  • Weakening of the heart muscle (cardiomyopathy)
  • Long-term kidney disease

Increased troponin levels may also result from certain medical procedures such as:

  • Cardiac angioplasty/stenting
  • Heart defibrillation or electrical cardioversion (purposeful shocking of the heart by medical personnel to correct an abnormal heart rhythm)
  • Open heart surgery
  • Radio-frequency ablation of the heart

References:

  • Anderson JL. ST segment elevation acute myocardial infarction and complications of myocardial infarction. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 73.
  • Levine GN, Bates ER, Blankenship JC, et al. 2015 ACC/AHA/SCAI Focused update on primary percutaneous coronary intervention for patients with ST-Elevation myocardial infarction: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation. 2016;133(11):1135-1147. PMID: 26490017 http://www.ncbi.nlm.nih.gov/pubmed/26490017.
  • Sabatine MS, Cannon CP. Approach to the patient with chest pain. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 50.
  • Tehrani DM, Seto AH. Third universal definition of myocardial infarction: update, caveats, differential diagnoses. Cleve Clin J Med. 2013;80(12):777-786. PMID: 24307162 http://www.ncbi.nlm.nih.gov/pubmed/24307162.

Disclaimer:

The information on healthmatters.io is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

 

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