A troponin test measures the levels troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. The more damage there is to the heart, the greater the amount of troponin T and I there will be in the blood.
TroponinI; TnI; TroponinT; TnT; Cardiac-specific troponin I; Cardiac-specific troponin T; cTnl; cTnT
A blood sample is needed.
No special steps are needed to prepare, most of the time.
You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.
The most common reason to perform this test is to see if a heart attack has occurred. Your doctor will order this test if you have chest pain and other signs of a heart attack. The test is usually repeated two more times over the next 6 to 24 hours.
Your doctor may also order this test if you have angina that is getting worse, but no other signs of a heart attack. (Angina is chest pain thought to be from a part of your heart not getting enough blood flow.)
The troponin test may also be done to help detect and evaluate other causes of heart injury.
The test may be done along with other cardiac marker tests, such as CPK isoenzymes or myoglobin.
Cardiac troponin levels are normally so low they cannot be detected with most blood tests.
Having normal troponin levels 12 hours after chest pain has started means a heart attack is unlikely.
A normal value range may vary slightly among different laboratories. Some labs use different measurements or test different samples. Also, some labs have different cutoff points for "normal" and "probable myocardial infarction." Talk to your doctor about the meaning of your specific test results.
Even a slight increase in the troponin level will often mean there has been some damage to the heart. Very high levels of troponin are a sign that a heart attack has occurred.
Most patients who have had a heart attack have increased troponin levels within 6 hours. After 12 hours, almost everyone who has had a heart attack will have raised levels.
Troponin levels may remain high for 1 to 2 weeks after a heart attack.
Increased troponin levels may also be due to:
Increased troponin levels may also result from certain medical procedures such as:
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O'Gara PT, et al. 2013: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction. Circulation. 2013;127:e363-e425.
Patil H, Vaidya O and Bogart D. A review of causes and systemic approach to cardiac troponin elevation. Clin Cardiol. 2011 Dec;34(12):723-8. PMID: 22120679 www.ncbi.nlm.nih.gov/pubmed/22120679.
Sabatine MS, Cannon CC. Approach to the patient with chest pain. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 53.