Cardiac troponins
proteinCardiac troponins (I, T, C) are released upon cardiomyocyte necrosis and are the definitive biomarker for myocardial injury in acute myocardial infarction.
Pathway placement
Cascade stepMyocardial injury (shared endpoint)
Confidencehigh
RationaleGold-standard myocardial necrosis marker; primary s8 anchor.
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-II67
A — assay feasibility68
E — evidence strength100
T1DI (composite)54
Specificity differential (R−C)+57.3
Direct evidence: higher in Type I (D=+2)
Type 1 MI (plaque rupture) produces troponin elevation; Type 2 MI and non-ischemic injury also elevate troponin but distinguish based on ischemic context
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 2
2anemia / acute blood lossn/a
3hypovolemia / dehydrationn/a
4tachyarrhythmian/a
5hypoxemia / respiratory failuremag 2
6hypertensive emergencyn/a
7high-demand / peri-operative stressmag 2
Coverage: 3/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 17 supporting references. See the discrimination table for all markers.
Assay & specimen
Class-level default (no specific cleared assay)— generic method inferred from analyte class; confirm against a specific product insert before use.
Specimen
Serum or plasma
Collection tube
Serum separator (gold/red-top, SST) · K2/K3-EDTA (lavender-top)
Method / principle
Sandwich immunoassay (ELISA) — research-grade unless a cleared assay exists
Reagent / substrate
Matched anti-target antibody pair (capture + labeled detection)
Platform
ELISA microplate or multiplex (Luminex/MSD)
Turnaround · availability
Send-out / research · Research-grade (no universal clinical assay)
Literature evidence(1)
- [New perspectives in the diagnostic approach to acute coronary syndrome].Recenti progressi in medicina · 2005 · PMID 15932030