Publication: Clinical usage of cardiac troponins [Kardiyak troponinler ve klinik kullanimi]
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Date
2001
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Abstract
Cardiac troponins are structural proteins found in the myocardial cells and take role in activation of actin-myosin complex. Troponins have 3 subunits as tropomyosine bining subunit (Troponin T), Calcium binding subunit (Troponin C) and inhibitor subunit (Troponin I). Measurement of serum levels of cardiac troponin T and I gives sensitive and specific information about myocardial cell injury. They are proved to be superior to previously used markers such as creatine kinase (CK) and MB fraction (CK-MB) measurements in identifying high risk patients with acute chest pain, myocardial infarction and myocardial ischemia. They are not affected by skeletal muscle injuries since myocardial and skeletal muscle has different troponin molecules. Troponin measurements gives idea about extend and severity of the myocardial necrosis as well as prognosis of the patient. In pediatric age group; patients with coronary anomalies, postoperative patients after arterial switch operations, cardiac transplantation, coronary lesions due to Kawasaki disease, myocardial injury due to neonatal asphyxia, trauma are potential fields of troponin T measurements. Cardiac troponins reaches their peak level 12-24 hours after myocardial injury. Troponin T is found in the serum of the patients for 14 days while Troponin I levels are found to be elevated for 5-7 days. Routine measurement of troponin levels in patients under myocardial infarction risk will provide early diagnosis and treatment of cardiac disease and decrease unnecessary hospitalization and interventions.