1. Troponin
By Julie Moore C
Dt204/2

2. What is Troponin? A complex of 3 regulatory proteins
Troponin C, troponin I, troponin T
Detected in skeletal and cardiac muscle contraction
Not in smooth muscle
Cardiac troponin is slightly different to Skeletal troponin structurally hence a potent and specific marker for cardiac disease.

3. Figure 1: Troponin Structure (Source: www.baspath.co.uk)

4. Troponin and Disease Troponin is used to diagnose a heart attack
Levels of troponin C and I are elevated
Figure 2: Levels of Troponin after Heart Attack
(Source: ylibobyqo.cuccfree.com)

5. Testing for Troponin
Test first ordered when someone enters hospital with suspected heart attack.
Typical blood test used
The test requested is called a Cardiac-specific Troponin I and Troponin T.
Normal levels should be below 0.01ng/ml.
For patients who present with acute coronary syndromes, troponin T values > or =0.01 ng/mL that are rising make the diagnosis of cardiac injury. Decreasing values are indicative of recent cardiac injury.
Troponin T values > or =0.01 ng/mL are a prognostic sign in patients with ischemic heart disease and most other situations. Clinical judgment is necessary to distinguish patients who have ischemic heart disease from those who do not. However, all patients with > or =0.01 ng/mL troponin T are at increased risk for cardiac events relative to patients with undetectable troponin T.
Figure 3: Blood Test from Arm
(Source:

6. ECG, physical exam and patient history needed to fully diagnose heart attack
Figure 4: ECG Printed Report
(Source:

7. Elecsys Troponin T Assay
Measures troponin T
Used in a hospital laboratory
Fully automated
9 minutes for results
Figure 5: Roche Elecsys Troponin T Test (Source:

8. Reference List
Cobas.com,. "Elecsys® Troponin T High Sensitive (Tnt-Hs)". N.p., Web. 15 Feb
Jaffe AS: 2001-A biomarker odyssey. Clin Chim Acta ,284:
Mayomedicallaboratories.com, (2016). TPNT - Clinical: Troponin T, Serum. [online] Available at: [Accessed 3 Feb. 2016].
Kelly, A. (2011) Performance Of A Sensitive Troponin Assay In The Early Diagnosis Of Acute Myocardial Infarction In The Emergency Department. Emergency Medicine Australasia ; 23(2)
Morrow D, Christeneson R, et al.(2007) National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Clinical Characteristics and Utilization of Biochemical Markers in Acute Coronary Syndromes. Journal of Clinical Chemistry. 53(4)552–574.
Sanchis, J et al.(2012) Usefulness Of High-Sensitivity Troponin T For The Evaluation Of Patients With Acute Chest Pain And No Or Minimal Myocardial Damage. American Heart Journal . 164(2)