Troponins as early markers of acute myocardial infarction

  • Sanjay Dixit
  • Allan S. Jaffe
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 193)


Acute myocardial infarction is a major cause of cardiovascular morbidity and death [1]. The diagnosis of acute myocardial infarction, as formally established by the World Health Organization requires at least two of the following criteria: a history of characteristic chest pain, evolutionary changes on the electrocardiogram, and elevation of serial cardiac enzymes [2]. Unfortunately, these findings are not always present in every patient with infarction. As many as one in three acute myocardial infarcrions is not recognized clinically by either the patient or physician because symptoms are often atypical or absent [3],[4]. Similarly, electrocardiographic findings in patients with possible acute myocardial infarction are often nonspecific. The electrocardiogram (ECG) has been reported to be misleading in 8% of patients with acute myocardial infarction and can be indeterminate in an additional 12% [5]. Furthermore, only a small percentage (10-20%) of the patients with chest discomfort or other symptoms compatible with cardiac ischemia subsequently have documentation of acute myocardial infarction. During the last quarter century, blood assays of a variety of protein markers of myocardial injury have played a pivotal role in the diagnosis of acute myocardial infarction [6]. These tests have helped to redefine acute myocardial infarction, often revealing degrees of myocardial necrosis that previously could not be detected. Indeed, because marker proteins are so much more sensitive and specific than the clinical presentation or the ECG, some have suggested that elevations alone in the proper clinical setting should be considered diagnostic of acute myocardial infarction [7].


Skeletal Muscle Acute Myocardial Infarction Creatine Kinase Unstable Angina Myocardial Injury 
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© Kluwer Academic Publishers 1997

Authors and Affiliations

  • Sanjay Dixit
  • Allan S. Jaffe

There are no affiliations available

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