A Review of Cardiac and Non-Cardiac Causes of Troponin Elevation and Clinical Relevance Part I: Cardiac Causes

Cardiac troponin elevation is found in numerous clinical conditions. The relevance of Cardiac troponin elevation in many patients tends to point towards poorer prognosis with few exceptions such as physical exercise and pericarditis. In the year 2007, a consensus statement from the Joint European Society of Cardiology and The American College of Cardiology committees redefined myocardial infarction (MI) as an elevation of cardiac troponin T (cTnT) or I (cTnI) in conjunction with clinical evidence of myocardial ischemia. Since then, cardiac troponins have been the pivotal marker for acute MI; still, the presence of a positive troponin occurs in several other conditions. It is even more challenging to determine the real significance of cardiac troponin elevation in this era of high sensitive assays which can detect mild increases in troponin levels. A thorough history and physical examination is indispensable to appropriately diagnose the cause of elevated troponin, especially if it is a mild elevation. This manuscript reviews the cardiac and non-cardiac clinical conditions in which cardiac troponin levels are an important factor in patient care.