Troponina: Estrutura, Fisiopatologia e Importancia Clínica para Além da Isquemia Miocárdica

cardiac troponins (i and t), introduced, into acute myocardial infarction definition, formerly in 2000, by the joint task force of american college of cardiology (acc) and european society of cardiology (esc), and updated in 2007, are considered, nowadays, the standard chemical biomarkers of myocardial necrosis, in face of their cardio-selectivity and high sign/noise ratio (the noise depending on troponina detection threshold, which is actually very low with current assays). the urge to diagnose myocardial infarction in the first 4h of symptoms presentation conducted to improvements in troponin assays, in such a way that currently is possible to detect extremely low levels of that protein in plasma, which leads inevitably to appearance of people (including those formerly named healthy) with detectable levels of troponina, whose meaning remains to be clarified. one possible explanation is that this troponina results from non-ischaemic myocardiocytes injury, in response to certain homodynamic/chemical stress, like hypoxia, systemic or pulmonary hypertension, renal failure or left ventricular hypertrophy, among others.