This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hamm, C. W. Articles by Katus, H. A. Search for Related Content PubMed PubMed Citation Articles by Hamm, C. W. Articles by Katus, H. A. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Coronary Artery Disease Related Collections Acute coronary syndromes Other diagnostic testing Related Article

(Circulation. 2002;106:2871.)
© 2002 American Heart Association, Inc.

Editorial

Cardiac Troponin Elevations in Patients Without Acute Coronary Syndrome

Christian W. Hamm, MD; Evangelos Giannitsis, MD; Hugo A. Katus, MD

From the Kerckhoff Heart Center (C.W.H.), Bad Nauheim, Germany, and the Department of Cardiology (E.G, H.A.K.), University of Heidelberg, Heidelberg, Germany.

Correspondence to Christian W. Hamm, MD, Kerckhoff Heart Center, Benekestrasse 2-8 D-61231, Bad Nauheim, Germany. E-mail christian.hamm@kerckhoff.med.uni-giessen.de

Key Words: Editorials • myocardium • kidney • myocarditis • embolism • tests

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Cardiac troponin T and troponin I are the most specific and sensitive laboratory markers of myocardial cell injury and therefore have replaced creatine kinase MB as the gold standard.^1,2 Accordingly, the new definition of acute myocardial infarctions was based on elevations of cardiac troponins in blood in the setting of ischemia.² The compelling clinical value of troponins resides in its superior prognostic potential in predicting the outcome of patients presenting with symptoms of unstable angina.³ Therefore, the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines and the European Society of Cardiology (ESC) Task Force Report on acute coronary syndromes without ST elevation have attributed troponin measurements a central role in the diagnostic work-up and therapeutic decision making.^4,5 It has been demonstrated that testing for troponins on admission and again after 6 to 12 hours provides better risk stratification than previously used algorithms based on the ECG and creatine kinase MB. The test results should be available within 30 to 60 minutes, because elevated troponins are helpful in identifying the patients who benefit most from early invasive strategies, glycoprotein IIb/IIIa antagonists, and low-molecular-weight heparins.⁵

See p 2941

Troponins in Cardiology Routine

Since their first introduction in the early nineties, troponin assays have been implemented in most emergency facilities as point-of-care tests or are offered on stat basis by the hospital central laboratories. Initially, there has been some confusion with regard to the correct cut-off values. Particularly irritating to many clinicians was the fact that the results with different troponin I assays were not comparable. This . . . [Full Text of this Article]

Related Article:

Predictive Value of Cardiac Troponin I and T for Subsequent Death in End-Stage Renal Disease

Fred S. Apple, MaryAnn M. Murakami, Lesly A. Pearce, and Charles A. Herzog
Circulation 2002 106: 2941-2945. [Abstract] [Full Text]

This article has been cited by other articles:

				K. Kurz, E. Giannitsis, J. Zehelein, and H. A. Katus Highly Sensitive Cardiac Troponin T Values Remain Constant after Brief Exercise- or Pharmacologic-Induced Reversible Myocardial Ischemia Clin. Chem., July 1, 2008; 54(7): 1234 - 1238. [Abstract] [Full Text] [PDF]

				A. E. Arai False positive or true positive troponin in patients presenting with chest pain but 'normal' coronary arteries: lessons from cardiac MRI Eur. Heart J., May 2, 2007; 28(10): 1175 - 1177. [Full Text] [PDF]

				M. Thielmann, P. Massoudy, M. Neuhauser, K. Tsagakis, G. Marggraf, M. Kamler, K. Mann, R. Erbel, and H. Jakob Prognostic Value of Preoperative Cardiac Troponin I in Patients Undergoing Emergency Coronary Artery Bypass Surgery With Non-ST-Elevation or ST-Elevation Acute Coronary Syndromes Circulation, July 4, 2006; 114(1_suppl): I-448 - I-453. [Abstract] [Full Text] [PDF]

				T. W. Wallace, S. M. Abdullah, M. H. Drazner, S. R. Das, A. Khera, D. K. McGuire, F. Wians, M. S. Sabatine, D. A. Morrow, and J. A. de Lemos Prevalence and Determinants of Troponin T Elevation in the General Population Circulation, April 25, 2006; 113(16): 1958 - 1965. [Abstract] [Full Text] [PDF]

				E. Giannitsis and H. A. Katus Risk Stratification in Pulmonary Embolism Based on Biomarkers and Echocardiography Circulation, September 13, 2005; 112(11): 1520 - 1521. [Full Text] [PDF]

				S. B. Rosalki, R. Roberts, H. A. Katus, E. Giannitsis, J. H. Ladenson, and F. S. Apple Cardiac Biomarkers for Detection of Myocardial Infarction: Perspectives from Past to Present Clin. Chem., November 1, 2004; 50(11): 2205 - 2213. [Abstract] [Full Text] [PDF]

				M. Kemp, J. Donovan, H. Higham, and J. Hooper Biochemical markers of myocardial injury Br. J. Anaesth., July 1, 2004; 93(1): 63 - 73. [Abstract] [Full Text] [PDF]

				A. S. Gami, A. Svatikova, R. Wolk, E. J. Olson, C. J. Duenwald, A. S. Jaffe, and V. K. Somers Cardiac Troponin T in Obstructive Sleep Apnea Chest, June 1, 2004; 125(6): 2097 - 2100. [Abstract] [Full Text] [PDF]

				C. Roongsritong, I. Warraich, and C. Bradley Common Causes of Troponin Elevations in the Absence of Acute Myocardial Infarction: Incidence and Clinical Significance Chest, May 1, 2004; 125(5): 1877 - 1884. [Abstract] [Full Text] [PDF]

				M. Imazio, B. Demichelis, E. Cecchi, R. Belli, A. Ghisio, M. Bobbio, and R. Trinchero Cardiac troponin i in acute pericarditis J. Am. Coll. Cardiol., December 17, 2003; 42(12): 2144 - 2148. [Abstract] [Full Text] [PDF]

				R. V. Luepker, F. S. Apple, R. H. Christenson, R. S. Crow, S. P. Fortmann, D. Goff, R. J. Goldberg, M. M. Hand, A. S. Jaffe, D. G. Julian, et al. Case Definitions for Acute Coronary Heart Disease in Epidemiology and Clinical Research Studies: A Statement From the AHA Council on Epidemiology and Prevention; AHA Statistics Committee; World Heart Federation Council on Epidemiology and Prevention; the European Society of Cardiology Working Group on Epidemiology and Prevention; Centers for Disease Control and Prevention; and the National Heart, Lung, and Blood Institute Circulation, November 18, 2003; 108(20): 2543 - 2549. [Full Text] [PDF]

				C. A. Herzog How to Manage the Renal Patient with Coronary Heart Disease: The Agony and the Ecstasy of Opinion-Based Medicine J. Am. Soc. Nephrol., October 1, 2003; 14(10): 2556 - 2572. [Full Text] [PDF]