Extensive troponin I and T modification detected serum from patients with acute myocardial infarction

Ralf Labugger, Lenny Organ, Christine Collier, Dan Atar, Jennifer E. Van Eyk

Research output: Contribution to journalArticlepeer-review

250 Scopus citations

Abstract

Background - Cardiac troponin I and T (cTnI and cTnT) are specific biochemical serum markers for acute myocardial infarction (AMI). However, cTnI diagnostic assays are plagued by difficulties, resulting in ≥20-fold differences in measured values. These discrepancies may result from the release of the numerous cTnI modification products that are present in ischemic myocardium. The resolution of these discrepancies requires an investigation of the exact forms of cTnI present in the bloodstream of patients after myocardial injury. Methods and Results - A western blot-direct serum analysis protocol was developed that allowed us to detect intact cTnI and a spectrum of up to 11 modified products in the serum from patients with AMI. For the first time, we document both a cTnI degradation pattern and the existence of phosphorylated cTnI in serum. The number and extent of these modifications reflect patterns similar to the time profiles of the routine clinical serum markers of total creatine kinase, creatine kinase-MB, and cTnI (determined by ELISA). Data from in vitro experiments, which were undertaken to study the degradation of human recombinant cTnI and cTnT when spiked in serum, indicate that some modification products present in patient serum existed in the myocardium and that recombinant cTnI alteration dramatically reduces the detectability of cTnI by the Immunol assay over time (our assay was unaffected). Conclusions - This pilot study defines, for the first time, what forms of cTnI and cTnT appear in the bloodstream of AMI patients, and it clarifies the lack of standardization between different cTnI diagnostic assays.

Original languageEnglish (US)
Pages (from-to)1221-1226
Number of pages6
JournalCirculation
Volume102
Issue number11
DOIs
StatePublished - Sep 12 2000
Externally publishedYes

Keywords

  • Biological markers
  • Blotting, western
  • Diagnosis
  • Myocardial infarction
  • Troponin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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