title: [Interpretation of highly sensitive troponin assays: acute or chronic myocardial damage?].
abstract: Troponin is the first choice in the diagnosis of acute myocardial infarction. Correct interpretation is challenging, because high sensitive troponin tests used today detect even the smallest cardiac damage.
  
  
  METHODS
  High sensitive troponin T (Roche) and troponin I (Mitsubishi Pathfast) and creatine-kinase activity were measured in 20 patients, each having two samples with the time lapse 3-9 hours.
  
  
  RESULTS
  In the group without acute myocardial infarction (n = 10) no significant increase in creatine-kinase and creatine-kinase-MB levels were seen, and the mild raise of troponins was due to other cardiovascular problems (atrial fibrillation, paroxysmal supraventricular tachycardia). With acute myocardial infarction (n = 10) a dramatic increase of troponin levels was found in the second samples, and also an increase of creatine-kinase and creatine-kinase-MB activity. According to Fischer-probe a twofold or higher increase of troponin implies 19-times higher risk of acute myocardial infarction in the case of troponin T and 8-times odds ratio at troponin I.
  
  
  CONCLUSIONS
  The patient's accompanying diseases should always be considered. If the troponin level is elevated, the measurement should be repeated within 3-6 hours. When troponin shows at least a twofold increase and the patient has chest pain or positive ECG, AMI is likely, and the patient needs special medical care. Although the first troponin level might be elevated if accompanying diseases cause chronic cardiac damage, it can be differentiated by a second troponin measurement.
authors: Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Laboratóriumi Medicina Intézet.
authors: Eszter
authors: E
authors: Szánthó
authors: Zoltán
authors: Z
authors: Szabó
authors: József
authors: J
authors: Varga
authors: György
authors: G
authors: Paragh
authors: Anna
authors: A
authors: V Oláh
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002908:Chronic Disease; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D013997:Time Factors; D014336:Troponin / Q000097:blood*
chemical_list: D015415:Biomarkers; D014336:Troponin; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form