What do troponin levels indicate in the evaluation of unstable angina?

Updated: Oct 01, 2020
  • Author: Walter Tan, MD, MS; Chief Editor: Eric H Yang, MD  more...
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Answer

Troponin I levels of 0.4 ng/mL or higher or troponin T levels of 0.1 ng/mL or higher are considered positive and have been associated with higher short-term and midterm mortality. Outcomes in troponin-positive patients have been improved by aggressive treatment strategies that include early cardiac catheterization. The temporal trends of these assays are helpful in interpreting difficult cases, and mild elevations of CK-MB or troponins from a lower baseline with subsequent falls in levels strongly indicate the occurrence of myonecrosis.

Troponin levels also may still capture evidence of a cardiac event in patients who delay their presentation to the hospital, because the serum half-life of troponin is longer than that of CK-MB and can remain elevated for 7-14 days after an event. Owing to their kinetics, however, cardiac troponins, once elevated, are much less useful in evaluating recurrent chest pain with myocardial injury, whereas CK-MB levels permit detection of reinfarction.


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