Implications of troponin testing in clinical medicine.
Abstract
During the past decade considerable research has been conducted into the use of cardiac
troponins, their diagnostic capability and their potential to allow risk stratification
in patients with acute chest pain. Determination of risk in patients with suspected
myocardial ischaemia is known to be as important as retrospective confirmation of
a diagnosis of myocardial infarction (MI). Therefore, creatine kinase (CK)-MB - the
former 'gold standard' in detecting myocardial necrosis - has been supplanted by new,
more accurate biomarkers.Measurement of cardiac troponin levels constitute a substantial
determinant in assessment of ischaemic heart disease, the presentations of which range
from silent ischaemia to acute MI. Under these conditions, troponin release is regarded
as surrogate marker of thrombus formation and peripheral embolization, and therefore
new therapeutic strategies are focusing on potent antithrombotic regimens to improve
long-term outcomes. Although elevated troponin levels are highly sensitive and specific
indicators of myocardial damage, they are not always reflective of acute ischaemic
coronary artery disease; other processes have been identified that cause elevations
in these biomarkers. However, because prognosis appears to be related to the presence
of troponins regardless of the mechanism of myocardial damage, clinicians increasingly
rely on troponin assays when formulating individual therapeutic plans.
Type
Journal articleSubject
acute coronary syndromeglycoprotein IIb/IIIa blockade
myocardial necrosis
risk stratification
troponin I
troponin T
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https://hdl.handle.net/10161/20593Published Version (Please cite this version)
10.1186/cvm-2-2-075Publication Info
Goldmann, Britta U; Christenson, Robert H; Hamm, Christian W; Meinertz, Thomas; &
Ohman, E Magnus (2001). Implications of troponin testing in clinical medicine. Current controlled trials in cardiovascular medicine, 2(2). pp. 75-84. 10.1186/cvm-2-2-075. Retrieved from https://hdl.handle.net/10161/20593.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Erik Magnus Ohman
Professor of Medicine
Dr. Ohman, Professor of Medicine, received medical degrees from the Royal College
of Surgeons in Ireland and the National University of Ireland (1984, Fellowship 1984-1987),
and completed his training in cardiology at Duke University (1987-1991), where he
has remained on faculty. In 2001, he became Chief of Cardiology at the University
of North Carolina at Chapel Hill, where he founded the UNC Heart Center and became
its first director. In 2005 he returned to Duke to pursue his interest in ad

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