Key result
Elevated cardiac troponins frequently occur in non-coronarogenic conditions such as renal failure, sepsis, and pulmonary embolism, requiring careful differential diagnosis in clinical practice.
Why the study?
Elevated troponin levels indicate myocardial damage but do not determine its cause or mechanism, and high-sensitivity assays detect minor damage occurring in many non-coronarogenic conditions.
Cardiac troponins can be elevated in a wide range of non-coronary conditions, necessitating careful clinical correlation to avoid misdiagnosing acute myocardial infarction.
Requires careful troponin interpretation to avoid misdiagnosing AMI; reinforces consensus on non-coronary elevations in ambiguous cases.
Cardiospecific isoforms of troponins are the most sensitive and specific biomarkers for the diagnosis of myocardial infarction. However, though elevated troponin levels indicate myocardial damage, they do not determine the cause and mechanism of the damage. With the new highly sensitive methods, very minor damages of the heart muscle can be detected. Myocardial damage can occur in many non-coronarogenic diseases. In this review, we discuss the mechanisms of elevation, the diagnostic value of cardiac troponins in the renal failure, tachyarrhythmias, endocarditis, myocarditis, pericarditis, sepsis, neurogenic pathologies (stroke), pulmonary embolism. In addition, we pay attention to the main reasons for a false-positive increase of the concentration of cardiac troponins: heterophilic antibodies, rheumatoid factor, alkaline phosphatase, cross-reactions with skeletal muscle troponins.
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Chaulin et al. (2020) conducted a review in Elevated cardiac troponins in non-coronarogenic diseases. Elevated cardiac troponins frequently occur in non-coronarogenic conditions such as renal failure, sepsis, and pulmonary embolism, requiring careful differential diagnosis in clinical practice.
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