Troponin T as the Best Biochemical Markers in the Detection of Myocardial Infarction.

We examined the value of serum levels of cardiac troponin T, serum creatine kinase MB (CK-MB) in the 155 patients within 24 hours of the onset of symptoms, presenting to the University Hospital “Mother Theresa” with a history of one or more episodes of angina and ECG confirmation of MI by the cardiologist. In preliminary observations, we found that the quantum of increase in troponin-T was disproportionate to that of CK-MB. This study was conducted in 6 different groups based on the level of serum troponin T. It was determined by means of a third generation assay (sandwich immuno assay) based on electrochemiluminescence (Elecsys, Roche Diagnostics). CK-MB was also determined on Coobas (Roche Diagnostics). According to the methods employed, control population should have troponin T levels <0.010 ng/ml and CKMB< 20U/L. Patients with symptoms of angina had significantly higher troponin-T and CK-MB levels when compared to healthy controls (p<0.001). In the group 3 with 33 patients the troponin-T value (0.1-1.9mg/ml), p=0.363 (r=0.363 ). The value of TNT were not proportionately elevated with CK-MB value (5.8-18.2U/L), p=0.018 (r=0.338). In cases of severe heart attack myocardial coefficient of correlation between two parameters under consideration resulted r = 0.954, with signifikance p <0.01. cases of severe heart attack myocardial coefficient of correlation between two parameters under consideration resulted r = 0.954, with signifikance p <0.01. Troponin-T levels can be used to detect early and minimal myocardial injury, but CK-MB is not sensitive enough to diagnose this. Initial troponin-T determination drawn at the time of the patients’ presentation is a powerful diagnostic tool for a rapid diagnosis rather than serial CKMB determination.