Differences in circulating cardiac troponin I and T in acute and chronic cardiac disease

Abstract Background Clinical practice and guidelines assume that cardiac troponin I (cTnI) cTnT are interchangeable, reflecting identical pathophysiological processes. However, it is unknown if cTnI really equivalent measures in different settings. Purpose To highlight potential differences the release of cTnT. Methods Large pooled cohort analysis including extensively characterized individuals, stratified into three groups: no disease (normal aging), chronic disease, acute disease. Circulating concentrations were measured blinded to clinical data using high-sensitivity assays (hs-cTnI-Architect, hs-cTnT-Elecsys) their ratio calculated. Findings validated a second hs-cTnI assay (hs-cTnI-Clarity). Results Among 8719 29% female, 10% had known 71% 20% Baseline characteristics renal function comparable between individuals with Normal aging (without disease) was associated disproportional increase versus (low cTnI/cTnT ratio, median 0.50, IQR 0.38–0.68). Although older, patients slightly higher (median 0.53, 0.37–0.79, p<0.05). In contrast, disproportionally elevated compared concentrations, resulting 1.96 (IQR 0.93–4.73, p<0.001). Internal validation confirmed these findings. Conclusion These findings suggest relevant greater normal Funding Acknowledgement Type funding sources: Foundation. Main source(s): Swiss National Science Foundation