Abstract
Cardiac troponins are protein complexes that have become the gold standard biomarkers in the detection of myocardial injury. The use of new-generation high-sensitivity assays, which can detect even small increases in troponin levels, resulted in an increase in the number of patients with elevated troponin concentrations. However, in this case there are more false-positive results. This makes it of paramount importance to set differential diagnosis among several noncoronary entities such as stroke, pulmonary embolism (PE), sepsis, acute perimyocarditis, Takotsubo, acute heart failure (HF), and tachycardia. Technological progress of high-sensitivity troponin assays may be helpful in detecting even slight elevations of troponin in individuals, a condition that is met in several different clinical pathologies. However, despite the fact that troponin elevation is indicative of myocardial necrosis, it does not elucidate the pathophysiologic mechanism that causes myocardial damage. The purpose of this chapter is to report clinical pathologies where elevated troponin concentrations are found and to cite studies that have used troponin in the prediction and evaluation of future events.
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Abbreviations
- ACC:
-
American College of Cardiology
- ACS:
-
Acute coronary syndromes
- AMI:
-
Acute myocardial infraction
- AV:
-
Atrioventricular
- CAD:
-
Coronary artery disease
- CKD:
-
Chronic kidney disease
- cTn:
-
Cardiac troponin
- ESC:
-
European Society of Cardiology
- ESRD:
-
End-stage renal disease
- HF:
-
Heart failure
- IL:
-
Interleukin
- MI:
-
Myocardial infraction
- MRI:
-
Magnetic resonance imaging
- PE:
-
Pulmonary embolism
- PSVT:
-
Paroxysmal supraventricular tachycardia
- SAH:
-
Subarachnoid hemorrhage
- SIRS:
-
Systemic inflammatory response
- SRCs:
-
Stress-related cardiomyopathies
- TAVI:
-
Transcatheter aortic valve implantation
- Tn:
-
Troponin
- TNF-α:
-
Tumor necrosis factor-α
- VARC:
-
Valve Academic Research Consortium
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Definitions
- Acute heart failure
-
Acute heart failure is a cardiac pathology that is characterized by the inability of the heart to provide enough volume in order to satisfy the body’s needs. Several entities are implicated with acute heart failure such as valvulopathies, coronary artery disease, and a damaged or inflamed heart.
- End-stage renal disease
-
End-stage renal disease is a clinical pathology that is characterized from declined function of kidneys. The function is not adequate for the everyday needs of the human body resulting to either hemodialysis or need for kidney transplantation. It is usually the subsequent consequence of chronic kidney disease, kidney injury/trauma, or major blood loss.
- High-sensitivity troponin assay
-
High-sensitivity troponin assays are troponin tests that have been designed to sense even slight elevations in concentrations in total population comparing with the conventional ones. The coefficient of variance (CV) of <10 % at the 99th percentile value in the population of interest has been proposed by experts.
- Subarachnoid hemorrhage
-
Subarachnoid hemorrhage is the blood concentration in the subarachnoid space. This space is found among the brain and the thin tissues that cover the brain. It might be a result of several bleeding types (arteriovenous malformation, bleeding disorder, bleeding from a cerebral aneurysm, head injury).
- TAVI
-
Transcatheter aortic valve implantation constitutes an alternative treatment option for patients with severe symptomatic aortic stenosis who cannot undergo surgery due to the fact that they are either considered as “high risk” or inoperable. It can be performed via the femoral or subclavian artery or direct through the ascending aorta or transapical.
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Vavuranakis, M., Kariori, M., Papaioannou, T.G., Tousoulis, D. (2015). Troponin Elevation Beyond Coronary Arteries. In: Patel, V., Preedy, V. (eds) Biomarkers in Cardiovascular Disease. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7741-5_41-1
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