title: Kinetics of high-sensitivity cardiac troponin T and I differ in patients with ST-segment elevation myocardial infarction treated by primary coronary intervention.
abstract: OBJECTIVE
  Cardiac biomarkers including troponins are the cornerstone of the biological definition of acute myocardial infarction. New high-sensitivity cardiac assays determining troponin T (hs-cTnT) as well as I ((hs-cTnI) from Abbott and s-cTnI from Siemens) raise concerns because of their unclear kinetics following the peak.
  
  
  OBJECTIVE
  This study aims to compare kinetics of creatine kinases, hs-cTnT, hs-cTnI and s-cTnI in patients with ST-segment elevation myocardial infarction (STEMI) treated by percutaneous coronary intervention.
  
  
  METHODS
  We prospectively studied 106 consecutive patients admitted in our institution for STEMI and treated by percutaneous coronary intervention. We evaluated for all the patients simultaneously kinetics of creatine kinases, hs-cTnT (Roche) and two different cTnIs (hs-cTnI from Abbott and s-cTnI from Siemens). Modelling of kinetics was realized using mixed effects with cubic splines.
  
  
  RESULTS
  Kinetics of markers showed a first peak at 10.7h (8.0-12.0) for creatine kinases, 11.8h (10.4-13.3) for hs-cTnT (Roche); 11.8h (10.7-11.8) for hs-cTnI from Abbott and 10.2h (8.7-11.6) for s-cTnI from Siemens, respectively. This peak was followed by a nearly log linear decrease for hs-cTnI/s-cTnI and creatine kinases in contrast to hs-cTnT, which appeared with a biphasic shape curve marked by a second peak at 76.9h (69.5-82.8). The analysis of the decrease in percentage of the peak value at 77h showed that hs-cTnT follows a twice lower decrease than other markers.
  
  
  CONCLUSIONS
  Kinetics of hs-cTnT, hs-cTnI and s-cTnI differ significantly with a linear decrease regarding both cTnI assays contrasting with a biphasic shape curve for hs-cTnT. This is of importance for clinical management of patients in routine settings especially in follow-up after STEMI including the suspicion of reinfarction.
authors.affiliation: Cardiology Department, Montpellier University Hospital, CHU-Montpellier, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Laugaudin
authors.affiliation: Biochemistry, Montpellier University Hospital, France.
authors.forename: Nils
authors.initials: N
authors.lastname: Kuster
authors.affiliation: Biochemistry, Montpellier University Hospital, France.
authors.forename: Amael
authors.initials: A
authors.lastname: Petiton
authors.affiliation: Cardiology Department, Montpellier University Hospital, CHU-Montpellier, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Leclercq
authors.affiliation: Cardiology Department, Montpellier University Hospital, CHU-Montpellier, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Gervasoni
authors.affiliation: Cardiology Department, Montpellier University Hospital, CHU-Montpellier, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Macia
authors.affiliation: Cardiology Department, Montpellier University Hospital, CHU-Montpellier, France.
authors.forename: Thien-Tri
authors.initials: TT
authors.lastname: Cung
authors.affiliation: Biochemistry, Montpellier University Hospital, France.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Dupuy
authors.affiliation: Cardiology Department, Montpellier University Hospital, CHU-Montpellier, France.
authors.forename: Kamila
authors.initials: K
authors.lastname: Solecki
authors.affiliation: Cardiology Department, Montpellier University Hospital, CHU-Montpellier, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Lattuca
authors.affiliation: Cardiology Department, Montpellier University Hospital, CHU-Montpellier, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Cade
authors.affiliation: Cardiology Department, Montpellier University Hospital, CHU-Montpellier, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Cransac
authors.affiliation: Biochemistry, Montpellier University Hospital, France PhyMedExp, University of Montpellier, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Cristol
authors.affiliation: Cardiology Department, Montpellier University Hospital, CHU-Montpellier, France PhyMedExp, University of Montpellier, France francois.roubille@gmail.com.
authors.forename: François
authors.initials: F
authors.lastname: Roubille
mesh_terms: D000368:Aged; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007700:Kinetics; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000378:metabolism / Q000628:therapy*; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
chemical_list: D019210:Troponin I; D020107:Troponin T; D003402:Creatine Kinase
keywords: Acute myocardial infarction; creatine kinase; high-sensitivity troponin; kinetics; percutaneous coronary intervention; troponin I; troponin T