Troponin T concentrations 72 hours after myocardial infarction as a serological estimate of infarct size.
BACKGROUND
After acute myocardial infarction, the structural protein T is released considerably longer than cytosolic creatine kinase (CK), CK MB isoenzyme (CK-MB), or lactate dehydrogenase (LDH) and late troponin T release (> 48 hours after onset of chest pain) appears to be less affected by early coronary reperfusion.


OBJECTIVE
To investigate the precision of a single measurement of circulating troponin T concentrations 72 hours after onset of chest pain compared with standard scintigraphic and enzymatic estimates of myocardial infarct size.


METHODS
Quantitative single photon emission computed tomography thallium-201 scintigraphy at rest was performed in 37 patients 2-3 weeks after myocardial infarction (group 1: 14 patients without early coronary reperfusion; group 2: 23 patients with early reperfusion achieved by thrombolytic therapy, by percutaneous transluminal coronary angioplasty, or by both).


RESULTS
In both groups, the number of myocardial segments with abnormal thallium-201 uptake indicating the individual extent of irreversible myocardial damage correlated significantly with the troponin T concentrations 72 hours after infarction as well as with peak concentrations of CK, CK-MB, and LDH.


CONCLUSIONS
The data show that a single measurement of circulating troponin T 72 hours after onset of chest pain--independent of reperfusion--is superior for the estimation of myocardial infarct size to measurement of peak CK, CK-MB, or LDH, which require serial determinations and depend on coronary reperfusion.
Licka
M
M
Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
Zimmermann
R
R
Zehelein
J
J
Dengler
T J
TJ
Katus
H A
HA
Kübler
W
W
D000328:Adult; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D009204:Myocardial Revascularization / Q000379:methods; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D015912:Thrombolytic Therapy / Q000379:methods; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D007527:Isoenzymes; D013794:Thallium Radioisotopes; D020107:Troponin T; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form