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(Circulation. 2006;114:1673-1675.)
© 2006 American Heart Association, Inc.

Editorial

Cardiac Troponin

Friend of the Cardiac Physician, Foe to the Cardiac Patient?

Alan H.B. Wu, PhD

From the Department of Laboratory Medicine, University of California, San Francisco, San Francisco General Hospital.

Correspondence to Alan Wu, PhD, San Francisco General Hospital, 1001 Potrero Ave, San Francisco, CA 94110. E-mail wualan@labmed2.ucsf.edu

Key Words: Editorials • autoantibodies • heart failure • myocardial infarction • troponin

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Troponin, an important regulatory protein of the thin filament (actin) of striated muscle, is a complex of 3 subunits: C, T, and I. Troponin T and I isoforms from the heart are structurally different from the corresponding forms found in skeletal muscle. Because of this distribution, the measurement of cardiac troponin T and I isoforms is superior to other serum biomarkers of cardiac disease such as creatine kinase (CK)-MB and myoglobin because these proteins are released in patients with skeletal muscle disease or injury, as well as the heart. Recently, the European Society of Cardiology (ESC) and American College of Cardiology (ACC) have redefined acute myocardial infarction (AMI) to be predicated on the finding of increased concentrations of cardiac troponin in the clinical context of myocardial ischemia.¹ These and other clinical practice guidelines^2–4 have led to a steady decline in the use of CK-MB and myoglobin as diagnostic laboratory tests for MI. Because there is a high tissue content of troponin within myocytes, measurement of troponin T and I has become important for risk stratification of patients for short-term adverse events (cardiac death, MI, readmission for recurrent ischemia, and need for revascularization).

Article p 1693

	Autoantibodies and Macromolecular Complexes

 
Despite the widespread use of cardiac troponin as a cardiac biomarker for diagnosis and risk stratification, there are still several unanswered biochemical and pathophysiological questions with reference to the release and detection of troponin and the clinical consequences of its circulation in blood. With regard to troponin release, most cardiology and laboratory medicine experts believe . . . [Full Text of this Article]

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