Clinical significance of elevated cardiac troponin

In life, some seemingly useless things often have different results when viewed from a different angle, so don’t just look at one side of things. The same is true in medicine. Sometimes some of our body indexes are abnormal, but they can be used as a guide for other diseases.

Troponin (Tn) is a regulatory protein for muscle tissue contraction. It is located on the thin filaments of contractile proteins and plays an important regulatory role in muscle contraction and relaxation. It contains three subtypes: fast-response type, slow-response type and cardiac troponin (cTn). The first two are related to skeletal muscle, while cardiac troponin only exists in cardiomyocytes. It is a complex composed of three subunits: troponin T (cTnT), troponin I (cTnI), and troponin C (cTnC). cTnT and cTnI are cardiomyocyte-specific antigens that are degraded from myocardial fibers when cardiomyocytes are damaged. Increased cTn in serum reflects damage to myocardial cells, and its specificity and sensitivity are higher than the myocardial enzyme spectrum commonly used in the past.

Troponin is a marker of myocardial injury and necrosis and has important clinical significance for the diagnosis and risk stratification of acute myocardial infarction. Elevated troponin values ​​indicate myocardial damage, which can be seen in acute myocardial infarction, unstable angina, pulmonary infarction, heart failure and other diseases that cause myocardial damage, such as pancreatitis and connective tissue diseases. The higher the value, the wider the range of damage. In patients with acute myocardial infarction, it begins to be released within 3 to 6 hours, reaches a peak within 10 to 24 hours, and the time to return to normal is 10 to 15 days and 5 to 7 days for cTnT and cTnI, respectively; elevated levels may also occur in some patients with renal insufficiency.

Elevated troponin combined with evidence of ischemia is helpful for the early diagnosis and treatment of type I myocardial infarction; understanding the changing pattern of elevated troponin is helpful for the differential diagnosis of elevated troponin. In case of transient myocardial damage caused by strenuous exercise, tachycardia, acute pulmonary embolism, etc., cTn may increase transiently and return to normal within 1 to 2 days; the increase in cTn caused by heart failure is chronic. These characteristics are helpful in distinguishing it from myocardial infarction.

Myocardial enzyme spectrum and troponin are mainly present in the myocardium. Increased index values ​​in laboratory tests should be a manifestation of myocardial damage, which is mostly seen in diseases such as myocardial infarction and myocarditis. Regarding the situation you mentioned, if laboratory tests show elevated myocardial enzyme spectrum and troponin, you should go to a regular hospital for examination in time to find out the cause and receive timely treatment. You need to rest, eat a light diet, and drink plenty of water.