Cardiac troponin I
TNNI3proteinCardiac troponin I is released from damaged cardiomyocytes following myocardial ischemia and necrosis and is the gold-standard biomarker for acute MI diagnosis, prognosis, and risk stratification.
Pathway placement
Cascade stepMyocardial injury (shared endpoint)
Confidencehigh
RationaleCardiac contractile protein released upon myocardial necrosis; primary biomarker for AMI diagnosis and risk stratification.
Druggability
DruggableYes
Known drugs / candidates1
Small-molecule tractableYes
Antibody tractableNo
EnsemblENSG00000129991
Type I vs Type II discrimination
ScoresShared / rises in both
R — rupture / Type-I100
C — confounder / Type-II58
A — assay feasibility96
E — evidence strength78
T1DI (composite)62
Specificity differential (R−C)+65.7
Direct evidence: higher in Type I (D=+2)
hs-cTnI: 1.4 ± 5.1 ng/L in T1MI vs 0.5 ± 1.1 ng/L in T2MI (P = 0.030)
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 2
2anemia / acute blood lossn/a
3hypovolemia / dehydrationmag 1
4tachyarrhythmian/a
5hypoxemia / respiratory failuremag 2
6hypertensive emergencymag 2
7high-demand / peri-operative stressn/a
Coverage: 4/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 13 supporting references. See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Serum or plasma
Collection tube
Serum separator (gold/red-top, SST) · Lithium heparin (green-top)
Method / principle
High-sensitivity chemiluminescent/ECL sandwich immunoassay
Reagent / substrate
Paired anti-cTnI monoclonal antibodies (capture+detection), acridinium/ruthenium label
Platform
Automated core-lab analyzer (Abbott Architect/Alinity, Siemens Atellica, Roche cobas); Abbott i-STAT POC
Turnaround · availability
STAT (~15–60 min) · FDA-cleared, universal
Human genetic evidence
0.269
Open Targets association (acute_MI)
Literature evidence(60)
- Cardiac myosin-binding protein C in ST-elevation myocardial infarction.European heart journal. Acute cardiovascular care · 2026 · PMID 41883174 · doi
- Infliximab Limits Injury in Myocardial Infarction.Journal of the American Heart Association · 2024 · PMID 38700022 · doi
- Native aortic root thrombus leading to myocardial infarction in a single ventricle patient.Cardiology in the young · 2024 · PMID 38752298 · doi
- Cardiovascular biomarker troponin I biosensor: Aptamer-gold-antibody hybrid on a metal oxide surface.Biotechnology and applied biochemistry · 2022 · PMID 35765758 · doi
- Association of Inflammatory and Hemostatic Parameters With Values of High Sensitive Troponin in Patients With Acute Coronary Syndrome.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2022 · PMID 35774044 · doi
- Association of albumin, fibrinogen, and modified proteins with acute coronary syndrome.PloS one · 2022 · PMID 35881574 · doi
- A novel circulating biomarker lnc-MALAT1 for acute myocardial infarction: Its relationship with disease risk, features, cytokines, and major adverse cardiovascular events.Journal of clinical laboratory analysis · 2022 · PMID 36378551 · doi
- A Novel Indicator of Myocardial Injury after Acute Myocardial Infarction: 'DPP-3'.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2022 · PMID 36514254 · doi
- Increased C reactive protein, cardiac troponin I and GLS are associated with myocardial inflammation in patients with non-ischemic heart failure.Scientific reports · 2021 · PMID 33542341 · doi
- Urgent Percutaneous Coronary Artery Intervention and Coronary Artery Bypass Grafting in STEMI Patients with Confirmed COVID-19.The heart surgery forum · 2021 · PMID 34173766 · doi
- The role of 5-HT7 receptors on isoproterenol-induced myocardial infarction in rats with high-fat diet exacerbated coronary endothelial dysfunction.Human & experimental toxicology · 2020 · PMID 32329363 · doi
- Association between serum lipoprotein-associated phospholipase A2, ischemic modified albumin and acute coronary syndrome: a cross-sectional study.Heart and vessels · 2019 · PMID 30963302 · doi
- Preoperative biomarker evaluation for the prediction of cardiovascular events after major vascular surgery.Journal of vascular surgery · 2019 · PMID 31653377 · doi
- Copeptin as a prognostic biomarker in acute myocardial infarction.International journal of cardiology · 2018 · PMID 30217427 · doi
- Cystatin C for Risk Stratification in Patients After an Acute Coronary Syndrome.Journal of the American Heart Association · 2018 · PMID 30371283 · doi
- Novel high-sensitivity cardiac troponin I assay in patients with suspected acute coronary syndrome.Heart (British Cardiac Society) · 2018 · PMID 30442743 · doi
- Ultrasmall superparamagnetic iron oxide nanoparticles acutely promote thrombosis and cardiac oxidative stress and DNA damage in mice.Particle and fibre toxicology · 2016 · PMID 27138375 · doi
- Troponin I and D-Dimer for Discriminating Acute Pulmonary Thromboembolism from Myocardial Infarction.Cardiology · 2016 · PMID 27816974 · doi
- Biomarkers in stable coronary heart disease, their modulation and cardiovascular risk: The LIPID biomarker study.International journal of cardiology · 2015 · PMID 26318511 · doi
- Distal coronary embolization following acute myocardial infarction increases early infarct size and late left ventricular wall thinning in a porcine model.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2015 · PMID 26620277 · doi
- Overview of cardiac markers in heart disease.Clinics in laboratory medicine · 2014 · PMID 24507783 · doi
- Of MIs and men--a historical perspective on the diagnostics of acute myocardial infarction.Seminars in thrombosis and hemostasis · 2014 · PMID 24967888 · doi
- Eosinophils count and periprocedural myocardial infarction in patients undergoing percutaneous coronary interventions.Atherosclerosis · 2014 · PMID 25055060 · doi
- [Essential cardiac biomarkers in myocardial infarction and heart failure].Herz · 2014 · PMID 25091086 · doi
- Coronary microemboli effects in preexisting acute infarcts in a swine model: cardiac MR imaging indices, injury biomarkers, and histopathologic assessment.Radiology · 2013 · PMID 23592769 · doi
- Degradation of troponin I in serum or plasma: mechanisms, and analytical and clinical implications.Seminars in thrombosis and hemostasis · 2012 · PMID 22422336 · doi
- [Early and late mortality of patients with community acquired pneumonia].Orvosi hetilap · 2012 · PMID 22668588 · doi
- The implications of serum enzymes and coagulation activities in postinfarction myocardial rupture.Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular · 2011 · PMID 21881705 · doi
- The role of postmortem cardiac markers in the diagnosis of acute myocardial infarction.Journal of forensic sciences · 2010 · PMID 20345772 · doi
- Circulating endothelial cells in coronary artery disease.Kardiologia polska · 2010 · PMID 20967702
- Peri-procedural myocardial injury during percutaneous coronary intervention: an important target for cardioprotection.European heart journal · 2010 · PMID 21037252 · doi
- Integration of proteomic-based tools for improved biomarkers of myocardial injury.Clinical chemistry · 2009 · PMID 20022985 · doi
- Thrombus precursor protein and clinical outcomes in patients with acute coronary syndromes.Journal of the American College of Cardiology · 2008 · PMID 18565400 · doi
- Platelet reactivity and the identification of acute coronary syndromes in the emergency department.Journal of thrombosis and thrombolysis · 2008 · PMID 18600429 · doi
- Biomarkers of cardiovascular damage and dysfunction--an overview.Heart, lung & circulation · 2007 · PMID 17618829 · doi
- Incremental prognostic value of C-reactive protein and N-terminal proB-type natriuretic peptide in acute coronary syndrome.Circulation journal : official journal of the Japanese Circulation Society · 2006 · PMID 17062957 · doi
- Diagnosis of acute coronary syndrome.American family physician · 2005 · PMID 16035692
- Association between early postoperative coagulation activation and peri-operative myocardial ischaemia in patients undergoing vascular surgery.Anaesthesia · 2005 · PMID 16288612 · doi
- Heart disease, clinical proteomics and mass spectrometry.Disease markers · 2004 · PMID 15502250 · doi
- [Inflammation and acute coronary syndromes].Revista espanola de cardiologia · 2001 · PMID 11591314 · doi
Showing 40 of 60 linked references.
Clinical trials(2)
- High-Sensitivity Cardiac Troponin I as a Diagnostic Marker for AMI Clinical Stage Classification in Acute Myocardial Infarction: A Retrospective Multicenter StudyNCT07163988 · COMPLETED
- Prehospital Point-of-Care High-Sensitivity Troponin I for Rule-Out of Acute Myocardial Infarction in Suspected Non-ST-Segment Elevation Acute Coronary Syndrome: A Pilot StudyNCT07563998 · NOT_YET_RECRUITING · Prehospital high-sensitivity cardiac troponin I measurement