- The Roche Elecsys 5th Generation Troponin T assay is the most sensitive and specific cardiac marker for myocardial damage.
- Elevations can be seen as soon as 1 hour after myocardial injury and remain elevated for more than 14 days.
- Troponin T is cardiac specific but not specific to acute MI. True detection of an MI requires serial testing to look for changes in levels along with the integration of clinical data.
- Chronic Troponin T elevations can be detected in clinically stable patients such as patients with ischemic or non‑ischemic heart failure, patients with different forms of cardiomyopathy, renal failure, sepsis and diabetes. Elevated concentrations of Troponin T can also occur in other clinical conditions such as myocarditis, heart contusion, pulmonary embolism and drug‑induced cardiotoxicity.
- Serial samples should be collected with collection times of 0 hour, 2 hours, 6 hours.
Immunoassay, Sandwich principle
Troponin values in other disease states
Troponins are released during the process of myocyte necrosis. While they are cardiac specific, they are not specific for MI and detectable levels may be seen in other disease states that involve the heart muscle (e.g. arrhythmia, acute aortic syndrome, acute heart failure, hypertensive crisis, myocarditis, pericarditis, pulmonary embolism and Takotsubo cardiomyopathy), so that ACC/ESC/AHA guidelines and the Universal Definition of MI recommend serial sampling with a rise or fall in troponin to distinguish between acute and chronic cTn elevations. Results should be interpreted in conjunction with clinical presentation including medical history, signs and symptoms, ECG data and biomarker concentrations.
Troponin T, High Sensitivity Troponin
Plasma or serum
Lithium heparin plasma separator tube is preferred but serum separator tube (SST) is also acceptable. If using an SST, please allow 20 minutes after collection for specimen to clot before centrifugation. All specimens must be centrifuged within four hours of collection.
Specimen Minimum Volume
2.0 mL of blood
Specimen Stability Information
Centrifuged specimen stable for 24 hours refrigerated or 12 months at -20C.
Rejected Due To
Samples showing visible signs of hemolysis may cause interference. Falsely depressed results are obtained when using samples with hemoglobin concentrations > 0.1 g/dL. (H index of 100).
Samples should not be taken from patients receiving therapy with high biotin doses (i.e. > 5 mg/day) until at least 8 hours following the last biotin administration.
Recommended draw: Baseline and 2 hours later and 6 hours later.
Glens Falls Hospital Chemistry and Special Chemistry Department
<= 14 ng/L for females
<= 22 ng/L for males
GFH lab will call to report all critical values ≥ 53 ng/L.
Day(s) and Time(s) Performed
As ordered. Turn around time 60 minutes for STAT specimens, four hours for routine specimens.
Specimen Retention Time