Turkiye Klinikleri Cardiovascular Sciences

.: REVIEW
Diagnostic Considerations and Analytical Characteristics of Methods for the Determination of Cardiac Troponins: Traditional Review
Kardiyak Troponinlerin Belirlenmesine Yönelik Yöntemlerin Tanısal Önemi ve Analitik Özellikleri: Geleneksel Derleme
Aleksey Michailovich CHAULINa
aDepartment of Cardiology, Samara State Medical University, Samara, RUSSIA
Turkiye Klinikleri J Cardiovasc Sci. 2021;33(3):149-60
doi: 10.5336/cardiosci.2021-84307
Article Language: EN
Full Text
ABSTRACT
 The laboratory methods for the determination of cardiac troponins (cTnI, cTnT) used nowadays are extremely diverse, which has a significant impact on our understanding of the biology and diagnostic value of cTnI and cTnT as biomarkers. The main classification of methods for the determination of cTnI and cTnT is based on the sensitivity of the immunoassay. Low- and moderately sensitive detection methods are known to be relatively low sensitive, which leads to a relatively late confirmation of cardiomyocyte death. Due to new highly sensitive methods used for the determination of cTnI and cTnT, designated as highly or ultrasensitive immunoassays (hs-TnT and hsTnT), we received new, revised data about the biology of cardiac troponin molecules. In particular, it became clear that they can be considered products of normal myocardium metabolism since hs-TnT and hs-TnT are detected in almost all healthy patients. It also turned out that hs-TnT and hs-TnT are differ by gender (in men, troponin concentration in the blood is higher than in women), age (in elderly patients, the levels of troponins are higher than in young ones) and circadian cycles (morning concentrations of troponins are higher than in the evening). A huge variety of methods for determining cTnI and cTnT, differing in their diagnostic capabilities, creates the need for tests in order to perform an unbiased assessment of analytical characteristics of each method. This review focuses on the most pressing issues related to the discussion of the biological characteristics of cardiac troponins and the analytical characteristics of troponin immunoassays from a historical and contemporary point of view.

Keywords: Troponin T; troponin I; analytical properties; 99th percentile; acute myocardial infarction
ÖZET
 cTnI ve cTnT'nin biyolojik belirteçler olarak biyolojisini ve tanı değerini anlamamızda önemli bir etkiye sahip olan günümüzde kullanılan kardiyak troponinlerin (cTnI, cTnT) tayini için kullanılan laboratuvar yöntemleri son derece çeşitlidir. cTn1 ve cTnT'nin tayini için kullanılan yöntemlerin ana sınıflandırması immunoassayin duyarlılığına dayanır. Düşük ve orta derecede duyarlı tespit yöntemlerinin görece düşük duyarlılığa sahip olduğu bilinmektedir, ki bu da kardiyomyosit ölümünün görece geç doğrulanmasına yol açar. cTnI ve cTnT'nin belirlenmesi için kullanılan, yüksek veya aşırı duyarlı immünolojik testler (hs-TnT ve hs-TnT) olarak adlandırılan yeni yüksek duyarlı yöntemler nedeniyle, kardiyak troponin moleküllerinin biyolojisi hakkında yeni, gözden geçirilmiş veriler aldık. Özellikle, hs-TnT ve hsTnT hemen hemen tüm sağlıklı hastalarda tespit edildiğinden, normal miyokard metabolizmasının ürünleri olarak kabul edilebilecekleri ortaya çıktı. Ayrıca hs-TnT ve hs-TnT'nin cinsiyete (erkeklerde kandaki troponin konsantrasyonu kadınlardan daha yüksek), yaşa (yaşlı hastalarda troponin seviyeleri gençlerden daha yüksek) ve sirkadiyen döngüler (sabah troponin konsantrasyonları akşamdan daha yüksektir) ile farklılık gösterdiği ortaya çıktı. cTnI ve cTnT'yi belirlemek için kullanılan, teşhis yeteneklerinde farklılık gösteren çok çeşitli yöntemler her yöntemin analitik özelliklerinin tarafsız bir değerlendirmesini yapmak için ihtiyaç yaratır. Bu derleme, kardiyak troponinlerin biyolojik özelliklerinin ve troponin immünolojik tahlillerinin analitik özelliklerinin tartışılmasıyla ilgili en acil konulara tarihsel ve çağdaş bir bakış açısıyla odaklanmaktadır.

Anahtar Kelimeler: Troponin T; troponin I; analitik özellikler; 99. yüzdelik dilim; akut miyokard infarktüsü
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5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com