Non-coronarogenic causes of increased cardiac troponins in clinical practice

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Abstract

Cardiospecific isoforms of troponins are the most sensitive and specific biomarkers for the diagnosis of myocardial infarction. However, though elevated troponin levels indicate myocardial damage, they do not determine the cause and mechanism of the damage. With the new highly sensitive methods, very minor damages of the heart muscle can be detected. Myocardial damage can occur in many non-coronarogenic diseases. In this review, we discuss the mechanisms of elevation, the diagnostic value of cardiac troponins in the renal failure, tachyarrhythmias, endocarditis, myocarditis, pericarditis, sepsis, neurogenic pathologies (stroke), pulmonary embolism. In addition, we pay attention to the main reasons for a false-positive increase of the concentration of cardiac troponins: heterophilic antibodies, rheumatoid factor, alkaline phosphatase, cross-reactions with skeletal muscle troponins.

About the authors

Aleksey M. Chaulin

Samara Regional Cardiology Dispensary; Samara State Medical University

Author for correspondence.
Email: alekseymichailovich22976@gmail.com
ORCID iD: 0000-0002-2712-0227
SPIN-code: 1107-0875

Assistant of the Department, Doctor

Russian Federation, 89, Chapayevskaya Street, Samara, 443099; 43, Aerodromnaya Street, Samara, 443070

Lilya S. Karslyan

Samara Regional Cardiology Dispensary; Samara State Medical University

Email: karslyan.L@yandex.ru
SPIN-code: 9209-1670

Candidate of Medical Sciences, Associate Professor of the Department, Doctor

Russian Federation, 89, Chapayevskaya Street, Samara, 443099; 43, Aerodromnaya Street, Samara, 443070

Dmitry V. Duplyakov

Samara Regional Cardiology Dispensary; Samara State Medical University

Email: duplyakov@yahoo.com
ORCID iD: 0000-0002-6453-2976
SPIN-code: 5665-9578

Doctor of Medical Sciences, Professor

Russian Federation, 89, Chapayevskaya Street, Samara, 443099; 43, Aerodromnaya Street, Samara, 443070

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2. Fig. 1. Location of troponins in a cardiomyocyte

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3. Fig. 2. Non-coronarogenic causes of increased concentration of cardiac troponins

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