Cardiac troponin
proteinCardiac troponin is released from damaged cardiomyocytes upon ischemic necrosis, serving as the diagnostic standard for myocardial infarction.
Pathway placement
Cascade stepMyocardial injury (shared endpoint)
Confidencehigh
RationaleAnchor for myocardial necrosis; defines MI diagnosis.
Druggability
Not assessed (no mapped human gene target).
Type I vs Type II discrimination
ScoresShared / rises in both
R — rupture / Type-I100
C — confounder / Type-II61
A — assay feasibility96
E — evidence strength65
T1DI (composite)43
Specificity differential (R−C)+38.9
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 2
2anemia / acute blood lossn/a
3hypovolemia / dehydrationmag 1
4tachyarrhythmiamag 2
5hypoxemia / respiratory failuremag 2
6hypertensive emergencymag 2
7high-demand / peri-operative stressmag 2
Coverage: 6/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 23 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
Literature evidence(4)
- Myocardial injury biomarkers and their assays: advances, insights, and future directions.Expert review of cardiovascular therapy · 2025 · PMID 41206584 · doi
- Type 2 myocardial infarction: a diagnostic and therapeutic challenge in contemporary cardiology.Internal and emergency medicine · 2022 · PMID 35157215 · doi
- Circulating miR-379 as a potential novel biomarker for diagnosis of acute myocardial infarction.European review for medical and pharmacological sciences · 2018 · PMID 29424915 · doi
- [Diagnosis of acute coronary syndrome].Deutsche medizinische Wochenschrift (1946) · 2014 · PMID 24446046 · doi
Clinical trials(7)
- High-sensitivity Cardiac Troponin and CK-MB Concentrations in Patients Undergoing Cardiac SurgeryNCT01913873 · PHASE4 · COMPLETED · serum concentration changes cardiac biomarkers
- Reference Interval Validation of High-Sensitivity Cardiac Troponin T Assay in Thai PopulationNCT03968016 · NA · COMPLETED · SYSMEX HLSCL
- Prospective Multicenter Study for Early Evaluation of Acute Chest PainNCT04122573 · UNKNOWN · Coronary angiography, CT angiography of aorta, CT angiography of pulmonary arteries., Electrocardiogram
- A Randomized Clinical Trial (RCT) of Population and Sex-specific Troponin Cutoffs for Ruling Out Acute Myocardial Infarction - The Danish Study of Population and Sex-Specific Cutoffs of TroponinNCT05336435 · NA · COMPLETED · Implementation of the new population and sex-specific 99th percentile URL for cardiac troponin
- Trial of Switching High-sensitivity Cardiac Troponin Assays in Suspected Acute Coronary Syndrome: an Interrupted Time Series Analysis (TWITCH-ED Study)NCT05748691 · COMPLETED · Clinical implementation of hs-cTnT
- 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