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Rise 2-4hr
Peak 14-18 hr
Normal 5-9 days 14 days
Methods ELISA, Chemiluminscent Assay
Troponin in risk stratification
and prognosis
NSTEMI patients had a large clinical benefit (55% reduction in
the odds of death or MI) when an early invasive strategy in
patients with only minor troponin elevations.
Non elevated troponin patients :no detectable benefit was
associated with early angiography and revascularization
STEMI reperfusion therapy should not be delayed waiting for
confirmatory biomarkers of myocardial injury
Prognosis :Patients presenting with clinical evidence of
ischemia and increased troponin have worse outcomes than
those without detectable troponin in the circulation
Methods of assay
Problematic standardization
Different assays measure different epitopes and
different fragments of cTnI. Thus, there are
differences in the responses of specific assays to the
various troponin forms
cTnI assays use antibodies specific to epitopes in the
central part of the troponin molecule that are not
affected by the numerous modifications found in
human blood noted .
The heterogeneity of assays is not a problem for cTnT
because there is only one assay.
Hs- troponin assays