Synonym: Cardiac troponin, cardiac troponin I (cTnI), cardiac troponin T (cTnT).

Troponin is a group of complex contractile proteins found in skeletal and heart (cardiac) muscle fibers that play an important role in regulating the interaction of muscular contraction through working on actin and myosin.  There are three types of these proteins are troponin I , troponin T, and troponin C.

Troponin C does not have a cardiac muscle-specific subunit and their working restricted on initiating contraction by binding calcium through calcium-binding subunit and moves troponin I,  while the other two types, Troponin I and troponin T proteins, they have cardiac muscle-specific subunits that mainly contribute to muscle contraction by pull the muscle fiber shorter.

Furthermore, when the cell of heart muscle damage they released the troponin to the blood that their level in normal individual very small to undetectable. As a result, troponin tests reflect the concentration of troponin that is in direct relation to heart damage as well as it helps in the evaluation if an individual has suffered a heart attack and other forms of heart injury.

Troponins I and T are elevated in blood post a heart attack within 3 or 4 hours after injury as well as may remain elevated for 10 to 14 days.

The Troponins I and T test is ordered to help in establishing a diagnosis of cardiac clinical situations like evaluation of Myocardial infarction (MI), evaluate myocardial cell damage and unstable angina, detection of reperfusion associated with coronary recanalization, evaluation of the severity of pulmonary emboli,  and congestive heart failure.

The Troponins I and T Test does not need any preparation steps by the patient. However, the patient should tell the healthcare provider about any drugs or supplements in use, since certain drugs may affect the result.

Reference values:

Troponin I: Less than 0.35 ng/mL

Troponin T: Less than 0.20 mcg/L

*Normal ranges may vary from one lab to another due to several factors, so it is important to discuss test results with a doctor.

Interpretation

The troponins I and T levels increase in several cases, for example acute myocardial infraction, minor myocardial damage after coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty, and Unstable angina pectoris.

Furthermore, there are many other diseases that lead to elevated troponin T besides the possibility of the presence of an ischemic mechanism like cardiac trauma (e.g., contusion, ablation, or pacing), congestive heart failure, hypertension, hypotension (often with arrhythmias), pulmonary embolism, renal failure, and myocarditis. The level of troponin T can be falsely elevated in such cases as severe skeletal muscle injury and in dialysis patient.

The Troponins I and T test is often performed by draw a blood sample from a vein of the patient’s arm to analyze and measure the amount of Troponins I and T in the sample of (1mL) volume. The method most probably used to detect the amount of Troponins I and T is enzyme immunoassay.

A healthcare provider orders troponins test with other several cardiac biomarkers, such as CK–MB or myoglobin. As the troponin test is more specific for heart injury so it the preferred test for a suspected heart attack.

Furthermore, when the troponin level elevated or even slightly elevated that means there are some damage occurred to the heart as well as if there a fluctuation in the troponin levels through the series of tests during several hours that indicated the person has had a heart attack or some other form of damage to the heart. The troponin elevated within 3 to 6 hours after heart injury and may remain elevated for 10 to 14 days and this is it cannot be sufficient to diagnose or rule out a heart attack and need to do a physical exam, clinical history, and ECG besides monitoring the troponin levels through test series.

The elevation of troponin levels may indicate that worsening condition and increased risk of a heart attack especially in angina patient, and the levels of troponin also can be elevated in other heart conditions such as myocarditis (heart inflammation), weakening of the heart (cardiomyopathy), or congestive heart failure, and with conditions unrelated to the heart, such as severe infections and kidney disease.

Troponins are a group of proteins that are found in skeletal and heart muscle fibers and it works to regulate muscle contraction. in addition , the troponin test helps to detect heart injury. There are three types of troponins are Troponin C, Troponin I and troponin T.

The troponin test is ordered to help in establishing a diagnosis of cardiac clinical situations like evaluation of Myocardial infarction (MI), evaluate myocardial cell damage and unstable angina.

The level of troponins I and T  increase in several cases, such as acute myocardial infarction, minor myocardial damage after coronary artery bypass graft surgery, or percutaneous transluminal coronary angioplasty.

However, in such cases as severe skeletal muscle injury and in dialysis patients the Troponin T level can be falsely elevated.