Troponin T
TNNT2proteinCardiac troponin T is released from damaged cardiomyocytes following myocardial ischemia and necrosis and is the primary biomarker for acute MI diagnosis, prognosis, and risk stratification.
Pathway placement
Cascade stepMyocardial injury (shared endpoint)
Confidencehigh
RationaleCardiac contractile protein released upon myocardial necrosis; gold-standard biomarker for AMI diagnosis and risk stratification.
Druggability
DruggableYes
Known drugs / candidates1
Small-molecule tractableYes
Antibody tractableNo
EnsemblENSG00000118194
Type I vs Type II discrimination
ScoresShared / rises in both
R — rupture / Type-I100
C — confounder / Type-II60
A — assay feasibility96
E — evidence strength85
T1DI (composite)57
Specificity differential (R−C)+40
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 2
2anemia / acute blood lossn/a
3hypovolemia / dehydrationn/a
4tachyarrhythmiamag 1
5hypoxemia / respiratory failuremag 2
6hypertensive emergencymag 2
7high-demand / peri-operative stressmag 2
Coverage: 5/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 27 supporting references. See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Serum or plasma (Li-heparin)
Collection tube
Lithium heparin (green-top) · Serum separator (gold/red-top, SST)
Method / principle
High-sensitivity ECL sandwich immunoassay
Reagent / substrate
Anti-cTnT monoclonal antibody pair, ruthenium label
Platform
Roche cobas/Elecsys (sole cTnT supplier)
Turnaround · availability
STAT (~18 min) · FDA-cleared
Human genetic evidence
0.266
Open Targets association (acute_MI)
Literature evidence(47)
- Combined complement and coagulation activation in ST-elevation myocardial infarction: associations with myocardial injury and dysfunction.Frontiers in immunology · 2025 · PMID 41262246 · doi
- Association of clinical, laboratory and imaging biomarkers with the occurrence of acute myocardial infarction in patients without standard modifiable risk factors - rationale and design of the "Beyond-SMuRFs Study".BMC cardiovascular disorders · 2023 · PMID 36959584 · doi
- Novel Insights Into the Effects of Interleukin 6 Antagonism in Non-ST-Segment-Elevation Myocardial Infarction Employing the SOMAscan Proteomics Platform.Journal of the American Heart Association · 2020 · PMID 32515246 · doi
- Prioritizing Candidates of Post-Myocardial Infarction Heart Failure Using Plasma Proteomics and Single-Cell Transcriptomics.Circulation · 2020 · PMID 32885678 · doi
- Novel biomarkers in the prognosis of patients with atherosclerotic coronary artery disease.Revista portuguesa de cardiologia · 2020 · PMID 33239161 · doi
- Preoperative biomarker evaluation for the prediction of cardiovascular events after major vascular surgery.Journal of vascular surgery · 2019 · PMID 31653377 · doi
- Point-of-care testing in primary care patients with acute cardiopulmonary symptoms: a systematic review.Family practice · 2018 · PMID 28985344 · doi
- Multiplex quantitative imaging of human myocardial infarction by mass spectrometry-immunohistochemistry.International journal of legal medicine · 2018 · PMID 29556718 · doi
- Amyloid-β (1-40) and Mortality in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome: A Cohort Study.Annals of internal medicine · 2018 · PMID 29799975 · doi
- The relationship between visfatin and cardiac markers on induced myocardial infarction in rats.Cytokine · 2018 · PMID 30477987 · doi
- Anti-inflammatory, Antithrombotic and Cardiac Remodeling Preventive Effects of Eugenol in Isoproterenol-Induced Myocardial Infarction in Wistar Rat.Cardiovascular toxicology · 2016 · PMID 26391896 · doi
- Plasma Levels of Soluble CD146 Reflect the Severity of Pulmonary Congestion Better Than Brain Natriuretic Peptide in Acute Coronary Syndrome.Annals of laboratory medicine · 2016 · PMID 27139601 · doi
- The Time Course of Markers of Neutrophil Extracellular Traps in Patients Undergoing Revascularisation for Acute Myocardial Infarction or Stable Angina Pectoris.Mediators of inflammation · 2016 · PMID 28074081 · doi
- Increased monomeric CRP levels in acute myocardial infarction: a possible new and specific biomarker for diagnosis and severity assessment of disease.Atherosclerosis · 2015 · PMID 25682033 · doi
- Long-term prognostic utility of pentraxin 3 and D-dimer as compared to high-sensitivity C-reactive protein and B-type natriuretic peptide in suspected acute coronary syndrome.European journal of preventive cardiology · 2015 · PMID 26635361 · 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
- [Essential cardiac biomarkers in myocardial infarction and heart failure].Herz · 2014 · PMID 25091086 · doi
- Platelet activation is associated with myocardial infarction in patients with pneumonia.Journal of the American College of Cardiology · 2014 · PMID 25444147 · doi
- LOX-1 in atherosclerotic disease.Clinica chimica acta; international journal of clinical chemistry · 2014 · PMID 25463747 · doi
- Degradation of troponin I in serum or plasma: mechanisms, and analytical and clinical implications.Seminars in thrombosis and hemostasis · 2012 · PMID 22422336 · doi
- Proteomic analysis of adverse outcomes in patients with acute coronary syndromes.Clinica chimica acta; international journal of clinical chemistry · 2012 · PMID 23195030 · doi
- D-dimer plasma levels in NSTE-ACS patient.Journal of the Medical Association of Thailand = Chotmaihet thangphaet · 2011 · PMID 21721427
- Utility of placental growth factor for prediction of 30-day adverse event in emergency department population with non-ST elevation acute coronary syndrome.Clinical laboratory · 2010 · PMID 20575469
- The value of procalcitonin, a novel inflammatory marker, in the diagnosis of myocardial infarction and evaluation of acute coronary syndrome patients.The Journal of emergency medicine · 2010 · PMID 20813483 · doi
- Peri-procedural myocardial injury during percutaneous coronary intervention: an important target for cardioprotection.European heart journal · 2010 · PMID 21037252 · doi
- ADAMTS4 level in patients with stable coronary artery disease and acute coronary syndromes.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2009 · PMID 19944557 · doi
- Noninvasive diagnosis of ruptured peripheral atherosclerotic lesions and myocardial infarction by antibody profiling.The Journal of clinical investigation · 2008 · PMID 18654662 · doi
- Biomarkers of cardiovascular damage and dysfunction--an overview.Heart, lung & circulation · 2007 · PMID 17618829 · doi
- A multimarker risk stratification approach to non-ST elevation acute coronary syndrome: implications of troponin T, CRP, NT pro-BNP and fibrin D-dimer levels.Journal of internal medicine · 2007 · PMID 17986200 · doi
- Antiphospholipid antibodies in young myocardial infarction patients.Indian journal of biochemistry & biophysics · 2007 · PMID 18320848
- [Multi-biomarker approach to acute coronary syndrome].Nihon rinsho. Japanese journal of clinical medicine · 2006 · PMID 16613186
- Soluble CD40L levels are regulated by the -3459 A>G polymorphism and predict myocardial infarction and the efficacy of antithrombotic treatment in non-ST elevation acute coronary syndrome.Arteriosclerosis, thrombosis, and vascular biology · 2006 · PMID 16627810 · doi
- Difference in elevation of N-terminal pro-BNP and conventional cardiac markers between patients with ST elevation vs non-ST elevation acute coronary syndrome.Circulation journal : official journal of the Japanese Circulation Society · 2006 · PMID 17062956 · doi
- Diagnosis of acute coronary syndrome.American family physician · 2005 · PMID 16035692
- Characterization of an original model of myocardial infarction provoked by coronary artery thrombosis induced by ferric chloride in pig.Thrombosis research · 2005 · PMID 16122556 · doi
- Association between early postoperative coagulation activation and peri-operative myocardial ischaemia in patients undergoing vascular surgery.Anaesthesia · 2005 · PMID 16288612 · doi
- Thrombin inhibitor reduces myocardial infarction in apoE-/- x LDLR-/- mice.American journal of physiology. Heart and circulatory physiology · 2004 · PMID 15031124 · doi
- Prognostic value of myeloperoxidase in patients with chest pain.The New England journal of medicine · 2003 · PMID 14573731 · doi
- Increased plasma concentration of fibrin monomer in acute myocardial infarction with early reperfusion.Coronary artery disease · 1996 · PMID 8813448 · doi
Showing 40 of 47 linked references.
Clinical trials(6)
- High-Sensitivity Troponin T and Coronary Computed Tomography Angiography for Rapid Diagnosis of Emergency Chest Pain: a Randomized Controlled StudyNCT01836211 · NA · TERMINATED · Fast strategy, Standard of care strategy
- Accelerated Rule-Out of Acute Myocardial Infarction, Using Copeptin and High Sensitive Troponin T - the AROMI TrialNCT02666326 · NA · COMPLETED · Accelerated, combined biomarker rule-out strategy for MI
- Can a Multi-marker Strategy Improve Risk Stratification and Expedite Discharge in Unstable Angina? A Comparison With High Sensitive Troponin TNCT03628586 · UNKNOWN
- Reference Interval Validation of High-Sensitivity Cardiac Troponin T Assay in Thai PopulationNCT03968016 · NA · COMPLETED · SYSMEX HLSCL
- Aiming Towards Evidence Based Interpretation of Cardiac Biomarkers in Patients Presenting With Chest Pain Using Point of Care AssaysNCT05354804 · NA · COMPLETED · Troponin I (Siemens VTli) 0/1 hour algorithm, Troponin T (Roche Diagnostics) 0/1 hour ESC algorithm
- Association Between One Lung Ventilation and Myocardial Injury Markers (Troponin T and I) in Thoracic Surgical Procedures : An Observational Cohort Study (OLVTIS)NCT07302243 · COMPLETED