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Troponin-I
Test CodeTROPI1
Alias/See Also
TROP, TROPI, TNIH, Troponin, High sensitivity troponin
Includes
Troponin I, Troponin Interpretation
Preferred Specimen
1.0 mL plasma (0.5 mL minimum)
Instructions
Serial samples are generally taken at 6-8 hour intervals over the first 48 hours after the onset of chest pain in patients suspected of suffering myocardial infarction.
Transport Container
PST (light green top). Red top and SST also acceptable
Specimen Stability
Room temperature: 8 hours, Refrigerated: 24 hours, Frozen: 40 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Grossly hemolyzed specimens are unacceptable.
Limitations
Patient samples may contain cardiac troponin-specific antibodies that could react in immunoassays to give depressed results.
Specimens that contain biotin at a concentration of 300 ng/mL demonstrate a less than 10% change in results. Biotin concentrations greater than this may lead to falsely depressed results. Testing specimens from renal dysfunction patients taking biotin may lead to false negative results. Do not use this test in patients with renal impairment (eGFR <60), unless it is confirmed that the patient is not taking biotin.
Specimens that contain biotin at a concentration of 300 ng/mL demonstrate a less than 10% change in results. Biotin concentrations greater than this may lead to falsely depressed results. Testing specimens from renal dysfunction patients taking biotin may lead to false negative results. Do not use this test in patients with renal impairment (eGFR <60), unless it is confirmed that the patient is not taking biotin.
Reference Range
Female: < 76 pg/mL
Male: < 86 pg/mL
Male: < 86 pg/mL
Clinical Significance
Cardiac troponin-I is released into blood within hours of the onset of symptoms of myocardial infarction and that it remains elevated for several days post-infarction. Measurement of cardiac troponin-I levels provide sensitive and specific determination of myocardial injury over a wide diagnostic window. Elevations in cardiac troponin-I levels have been observed across a spectrum of acute coronary syndromes including Q-wave MI, non-Q-wave MI and unstable angina. A significantly higher incidence of mortality has been observed in patients with non-Q-wave MI and unstable angina who have detectable levels of cardiac troponin-I. This suggests that cardiac troponin-I provides a means for risk stratification of these individuals.
