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Troponin I

The role of troponin I (highly sensitive) in the body

Troponin I (cTnI) is a key biomarker of myocardial damageand is part of the contractile system of the heart muscle. Normally, it is practically not detected in the blood.

Main functions:

  1. Regulation of muscle contraction (together with troponin T and C)
  2. Specific marker of cardiomyocyte necrosis
  3. Diagnosis of myocardial infarction (highly sensitive method detects even microinfarcts)

Norm of troponin I (highly sensitive) in the blood

ParameterValue
Healthy adults<0.04 ng/mL
Myocardial infarction threshold>0.5 ng/mL (with rising trend)
“Grey zone”0.04–0.5 ng/mL (repeat testing required in 3–6 hours)

Note: References depend on the analysis method. In the elderly, a slight increase is acceptable (up to 0.1 ng / ml).

Reduced Troponin I

Situations:

  • Normal condition (no blood or trace amounts)
  • False-low result (sample hemolysis)

It has no clinical significance.

Increased Troponin I

Critical level:

  • > 0.5 ng / ml with a 2-fold increase in repeated measurement-heart attack diagnosis

Main reasons:

  1. Acute coronary syndrome (infarction, unstable angina)
  2. Myocarditis
  3. PE (pulmonary embolism)
  4. Heart injury (contusion, surgery)
  5. CRF (chronic renal failure)

Symptoms:

  • Pressing pain behind the sternum (>15 min)
  • Shortnessof breath, cold sweat
  • Nausea/vomiting
  • Rhythm disorders
  • Loss of consciousness (with a massive heart attack)

What should I do if there are deviations?

  1. At the level of > 0.5 ng / ml:
  • Urgent ECG
  • Control after 3-6 hours (evaluate the dynamics)
  • Hospitalization in a cardiac hospital
  1. In the ‘gray zone’ (0.04-0.5 ng / ml):
  • Exclude: myocarditis, PE, sepsis
  • Optional: Echocardiography, coronary angiography

Important:

  • Highly sensitive troponin detects myocardial damage as early as 1-3 hours after the onset of symptoms!
  • A false positive result is possible with: hemolysis, kidney failure, muscle injury.