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Licensed Unlicensed Requires Authentication Published by De Gruyter June 1, 2005

Comparison of cardiac troponin T and I in healthy men and in aortic valve replacement

  • Eberhard Gurr and Knut Leitz


Troponins are of outstanding importance for the diagnosis of myocardial infarction. Cardiac troponin T (cTnT) and the various cardiac troponin I (cTnI) assays differ with respect to method comparison, diagnostic sensitivity and diagnostic specificity. To understand the differences in the diagnostic behavior of troponin assays, AccuTnI and Elecsys Troponin STAT were used in a group of healthy men and in the follow-up of patients with aortic valve replacement (AVR). Within the healthy subjects AccuTnI was able to differentiate two subgroups from each other, whereas the cTnT concentrations of all subjects were below the detection limit. In AVR patients, cTnT and cTnI correlated sufficiently, if the postoperative periods were taken into consideration. There was a rapid increase in cTnI within 24 h. In contrast, a broad peak was evident for cTnT between 48 and 120 h. The results emphasize more the differences in the release of cTnI and cTnT from the cytoplasm and the thin filaments of the cardiomyocytes than the modifications of the troponins circulating in the blood.

Corresponding author: Prof. Dr. Eberhard Gurr, Department of Clinical Chemistry, Zentralkrankenhaus Links der Weser, Senator-Wessling-Str. 1, 28277 Bremen, Germany. Phone: +49-421-8791670, Fax: +49-421-8791672, E-mail:


1 The Joint European Society of Cardiology/American College of Cardiology Committee. Myocardial infarction redefined - a consensus document of the joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol 2000; 36:959–69.10.1016/S0735-1097(00)00804-4Search in Google Scholar

2 Wu AHB, Fen YJ, Moore R, Apple FS, McPherson PH, Buechler KF, et al. Characterisation of cardiac troponin subunit release into serum after acute myocardial infarction and comparison of assays for troponin T and I. Clin Chem 1998; 44:1198–208.10.1093/clinchem/44.6.1198Search in Google Scholar

3 Katrukha A, Bereznikova AV, Filatov VL, Esakova TV, Kolosova OV, Petterson K, et al. Degradation of cardiac troponin I: implication for reliable immunodetection. Clin Chem 1998; 44:2433–40.10.1093/clinchem/44.12.2433Search in Google Scholar

4 Chandra M, Dong WJ, Pan BS, Cheung HC, Solaro RJ. Effects of protein kinase A phosphorylation on signaling between cardiac troponin I and the N-terminal domain of cardiac troponin C. Biochemistry 1997; 36:13305–11.10.1021/bi9710129Search in Google Scholar PubMed

5 Ingraham RF, Hodges RS. Effects of Ca2+ and subunit interaction on surface accessibility of cysteine residues of cardiac troponin. Biochemistry 1988; 27:5891–8.10.1021/bi00416a011Search in Google Scholar PubMed

6 Gerhardt W, Katus H, Ravkilde J, Hamm C, Jorgensen PJ, Peheim E, et al. S-Troponin T in suspected ischemic myocardial injury compared with mass and catalytic concentrations of S-creatine kinase isoenzyme MB. Clin Chem 1991; 38:1194–5.10.1093/clinchem/38.6.1194Search in Google Scholar

7 Baum H, Braun S, Gerhardt W, Gilson G, Hafner G, Muller-Bardorff M, et al. Multicenter evaluation of a second generation assay for cardiac troponin T. Clin Chem 1997; 43:1877–84.10.1093/clinchem/43.10.1877Search in Google Scholar

8 Hallermeyer K, Klenner D, Vogel R. Use of recombinant human cardiac troponin T for standardization of third generation troponin T methods. Scand J Clin Lab Invest Suppl 1999; 230:128–31.10.1080/00365519909168336Search in Google Scholar

9 Ossendorf M, Eberle B, Ehrenthal W, Rupprecht HJ, Mayer E, Kumpmann K, et al. Analytical and clinical evaluation of the Access troponin immunoassay. Clin Lab 1997; 43:627–36.Search in Google Scholar

10 Apple FS, Maturen AJ, Mullins RE, Painter PC, Pessin-Minsley MS, Webster RA, et al. Multicenter clinical and analytical evaluation of the AxSYM troponin I immunoassay to assist in the diagnosis of myocardial infarction. Clin Chem 1999; 45:206–12.10.1093/clinchem/45.2.206Search in Google Scholar

11 Hafner G, Peetz D, Dati F, Post F, Blankenberg S, Peivandi AA, et al. Analytical and clinical evaluation of troponin Gurr and Leitz: Cardiac troponins compared 1025 I determination on Dimension RXL-HM. Clin Chem Lab Med 2000; 38:355–61.10.1515/CCLM.2000.051Search in Google Scholar PubMed

12 Collinson PO, Wiggins N, Gaze DC. Clinical evaluation of the ACS: 180 cardiac troponin I assay. Ann Clin Biochem 2001; 38:509–19.10.1177/000456320103800508Search in Google Scholar

13 Lestin M, Hergert M, Lestin HG, Brinker C, Storm H, Kuhrt E, et al. Evaluation of the chemiluminescence immunoassays for troponin I, myoglobin and CKMB using the IMMULITE system in comparison to other measuring systems. Clin Lab 2002; 48:211–21.Search in Google Scholar

14 Uetwiller-Geiger D, Wu A, Olson MD, Darte C, Woodrum D, Roberts S, et al. Multicenter evaluation of an automated assay for troponin I. Clin Chem 2002; 48:869–76.10.1093/clinchem/48.6.869Search in Google Scholar

15 ver Elst KM, Chapelle JP, Boland P, Demolder JS, Gorus FK. Analytical and clinical evaluation of the Abbott AxSYM cardiac troponin I assay. Am J Clin Pathol 1999; 112:739–41.10.1093/ajcp/112.6.745Search in Google Scholar

16 Haug C, Bachem MG, Woehrle H, Hetzel M, Gruenert A. Evaluation of two modified cardiac troponin I enzyme immunoassays. Clin Chem Lab Med 2002; 40:837–9.10.1515/CCLM.2002.145Search in Google Scholar

17 Chapelle JP. Cardiac troponin I and troponin T: recent players in the field of myocardial markers. Clin Chem Lab Med 1999; 37:11–20.10.1515/CCLM.1999.002Search in Google Scholar

18 Ohmann EM, Amstrong PW, Christenson RH, Granger CB, Katus HA, Hamm CW, et al. Cardiac troponin T levels for the risk stratification in acute myocardial ischemia. N Engl J Med 1996; 335:1333–41.10.1056/NEJM199610313351801Search in Google Scholar

19 Antman EM, Tanasijevic MJ, Thompson B, Schactman M, McCabe CH, Cannon CP, et al. Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med 1996; 335:1342–9.10.1056/NEJM199610313351802Search in Google Scholar

20 Christenson RH, Show-Hong D, Newby K, Ohman EM, Califf PW, Katus HA, et al. Cardiac troponin T and cardiac troponin I: relative values in short-term risk stratification of patients with acute coronary syndromes. Clin Chem 1998; 44:494–501.Search in Google Scholar

21 Hetland O, Dickstein K. Cardiac troponins I and T in patients with suspected acute coronary syndrome: a comparative study in a routine setting. Clin Chem 1998; 44:1430–6.10.1093/clinchem/44.7.1430Search in Google Scholar

22 Heeschen C, Hamm CW, Goldmann B, Deu A, Langenbrink L, White HD. Troponin concentrations for the stratification of patients with acute coronary syndromes in relation to therapeutic efficacy of tirofiban. PRISM Study Investigators. Platelet receptor inhibition in ischemic syndrome management. Lancet 1999; 354:1757–62.10.1016/S0140-6736(99)10285-XSearch in Google Scholar

23 Heeschen C, Deu A, Langenbrink L, Goldmann BU, Hamm CW. Analytical and diagnostic performance of troponin assays in patients suspicious for acute coronary syndromes. Clin Biochem 2000; 33:359–68.10.1016/S0009-9120(00)00144-2Search in Google Scholar

24 Kleiman NS, Lakkis N, Cannon CP, Murphy SA, DiBattiste PM, Demopoulos LA, et al. Prospective analysis of creatine kinase muscle-brain fraction and comparison with troponin T to predict cardiac risk and benefit of an invasive strategy in patients with non-ST-elevation acute coronary syndromes. J Am Coll Cardiol 2002; 40:1044–50.10.1016/S0735-1097(02)02119-8Search in Google Scholar

25 McKay RG, Boden WE. Small peptide GP IIb/IIIa receptor inhibitors as upstream therapy in non-ST-segment elevation acute coronary syndromes: results of the PURSUIT, PRISM, PRISM-PLUS, TACTICS, and PARAGON trials. Curr Opin Cardiol 2001; 16:364–9.10.1097/00001573-200111000-00009Search in Google Scholar

26 Venge P, Lagerquist B, Diderholm E, Lindahl B, Wallentin L. Clinical performance of three cardiac troponin assays in patients with unstable coronary artery disease. Am J Cardiol 2002; 89:1035–41.10.1016/S0002-9149(02)02271-3Search in Google Scholar

27 Chapelle JP, Dubois B, Bovy C, Aldenhoff MC, Gielen J, Rorive G. Comparison of plasma cardiac troponin T and I in chronically hemodialyzed patients in relation to cardiac status and age. Clin Chem Lab Med 2002; 40:240–5.10.1515/CCLM.2002.039Search in Google Scholar PubMed

28 Morrow D, Rifai N, Tanasijevic MJ, Wybenga DR, de Lemos JA, Antman EM. Clinical efficacy of three assays for cardiac troponin I for risk stratification in acute coronary syndromes: a thrombolysis in myocardial infarction (TIMI) IIB substudy. Clin Chem 2000; 46:453–60.10.1093/clinchem/46.4.453Search in Google Scholar

29 Katrukha A, Bereznikova A, Pettersson K. New approach to standardisation of human cardiac troponin I. Scand J Clin Lab Invest Suppl 1999; 230:124–7.10.1080/00365519909168335Search in Google Scholar

30 Apple FS. Clinical and analytical standardization issues confronting cardiac troponin I. Clin Chem 1999; 45:18–20.10.1093/clinchem/45.1.18Search in Google Scholar

31 Jaffe AS, Ravkilde J, Roberts R, Naslund U, Apple FS, Galvani M, et al. It’s time for a change to a troponin standard. Circulation 2000; 102;1216–20.10.1161/01.CIR.102.11.1216Search in Google Scholar PubMed

32 Christenson RH, Duh SH, Apple FS, Bodor GS, Bunk, DM, Dalluge J, et al. Standardization of cardiac troponin I assays: round robin of ten candidate reference materials. Clin Chem 2001; 47:431–7.10.1093/clinchem/47.3.431Search in Google Scholar

33 Apple FS, Wu AH, Jaffe AS. European Society of Cardiology and American College of Cardiology guidelines for redefinition of myocardial infarction: how to use existing assays clinically and for clinical trials. Am Heart J 2002; 144:981–6.10.1067/mhj.2002.124048Search in Google Scholar PubMed

34 Multicenter evaluation of troponin T (3rd generation assay). Roche documentation, 1999.Search in Google Scholar

35 Passing H, Bablok W. A new biometrical procedure for testing the equality of measurements from two different analytical methods. J Clin Chem Clin Biochem 1983; 21:709–20.Search in Google Scholar

36 Passing H, Bablok W. Comparison of several regression procedures for method comparison studies and determination of sample sizes. J Clin Chem Clin Biochem 1984; 22:431–45.Search in Google Scholar

37 Koller A. Exercise-induced increases in cardiac troponins and prothrombotic markers. Med Sci Sports Exerc 2003; 35:444–8.10.1249/01.MSS.0000053736.51903.0ESearch in Google Scholar

38 Yeo KTJ, Quinn-Hall KS, Bateman SW, Fischer GA, Wieczorek S, Wu AHB. Functional sensitivity of cardiac troponin assays and its implication for risk stratification for patients with acute coronary syndromes. In: Adams JE, Apple FS, Jaffe AS, Wu AHB, editors. Markers in cardiology: current and future clinical applications. American Heart Association Monograph Series. Armonk, NY: American Heart Association, 2001:23–30.Search in Google Scholar

39 Hamm CW, Giannitsis E, Katus HA. Cardiac troponin elevations in patients without acute coronary syndrome. Circulation 2002; 106:2871–3.10.1161/01.CIR.0000044342.50593.63Search in Google Scholar

40 Gerhardt W, Nordin G, Herbert AK, Burzell BL, Isaksson A, Gustavsson E, et al. Troponin T and I assays decreased concentrations in heparin plasma compared with serum: lower recoveries in early than in late phases of myocardial injury. Clin Chem 2000; 46:817–21.10.1093/clinchem/46.6.817Search in Google Scholar

41 Stiegler H, Fischer Y, Vazquez-Jimenez JF, Graf J, Filzmaier K, Fausten B, et. al. Lower cardiac troponin T and I results in heparin plasma than in serum. Clin Chem 2000; 46:1338–44.10.1093/clinchem/46.9.1338Search in Google Scholar

42 Speth M, Seibold K, Katz N. Interaction between heparin and cardiac troponin T and troponin I from patients after coronary bypass surgery. Clin Biochem 2002; 35:355–62.10.1016/S0009-9120(02)00328-4Search in Google Scholar

43 Opfermann UT, Peivandi AA, Dahm M, Hilgenstock H, Hafner G, Loos A, et al. Postoperative patterns and kinetics of cTnI, cTnT, CK-MB-activity and CK-activity after elective aortic valve replacement. Swiss Med Wkly 2001; 131:550–5.Search in Google Scholar

44 Giuliani I, Bertinchant JP, Granier C, Laprade M, Chocron S, Toubin G, et al. Determination of cardiac troponin I forms in the blood of patients with acute myocardial infarction and patients receiving crystalloid or cold blood cardioplegia. Clin Chem 1999; 45:213–22.10.1093/clinchem/45.2.213Search in Google Scholar

45 Etievent JP, Chocron S, Toubin G, Taberlet C, Alwan K, Clement F, et al. Use of cardiac troponin I as a marker of perioperative myocardial ischemia. Ann Thorac Surg 1995; 59:1192–4.10.1016/0003-4975(95)00129-9Search in Google Scholar

46 Chocron S, Alwan K, Toubin G, Clement F, Kaili D, Taberlet C, et al. Crystalloid cardioplegia rate of delivery and 1026 Gurr and Leitz: Cardiac troponins compared cardiac troponin I release. Ann Thorac Surg 1996; 62:481–5.10.1016/0003-4975(96)00312-8Search in Google Scholar

47 Alonsozana GL, Duh SH, Christenson RH. Cardiac troponin I measurement with the AxSYM: evaluation and comparison with the Stratus and Access system. Clin Chem 1998; 44:A128.10.1093/clinchem/44.1.52Search in Google Scholar

Received: 2003-4-17
Accepted: 2004-8-20
Published Online: 2005-6-1
Published in Print: 2004-9-1

© Walter de Gruyter

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