145 - Troponin I (hs)
- Serum, 1ml
Troponin is a myofibrillar regulatory protein complex. It causes the binding of the troponin complex to tropomyosin. In ischaemia of the muscle cells, the troponins are released. The cardiac troponins have a different amino acid sequence than those of skeletal muscle. As a result, the cardiospecific subunits can be selectively determined by means of modern test methods. Due to this high specificity and sensitivity, the marker is suitable for the initial diagnosis of acute myocardial infarction. It has also been shown that microinfarcts in the context of unstable angina pectoris also increase troponin (in the case of negative CK, CK-MB, myoglobin). In addition, the disruptive effects of nonspecific CK elevations (e.g., postoperatively) are eliminated. Myocardial damage is to be assumed if the troponin value rises above the standard value (99th percentile). Highly sensitive troponins (hs troponin) can already be detected about 3 hours after the onset of symptoms. Above all, the dynamics of troponin values in differential diagnosis is important. If acute myocardial damage is suspected, a second measurement will be taken three hours after the first measurement. The higher the value of the first measurement and the greater the change over time, the more likely a myocardial infarction. An acute myocardial infarction can be excluded with high certainty if the troponin value remains below the normal value for 3 hours or does not change.
Increases: Myocardial damage (increase about 3 hours after pain). Unstable angina pectoris with microinfections. Successful thrombolysis: steep rise.
Notes: wrongly elevated: chronic renal insufficiency.
Values above the reference level of up to 300ng / l do not rule out infarction, but may be due to other causes: angina pectoris, unstable angina pectoris, congestive heart failure, myocarditis, heart surgery or invasive examinations, and other non-cardiac conditions such as pulmonary embolism, renal failure, and sepsis ,
Patients with unstable angina pectoris and elevated troponin show a higher risk of complications than patients with normal troponin.
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