Sign in →

Test ID: TRPS Troponin T, 5th Generation, Plasma


Specimen Required


Collection Container/Tube:

Preferred: Lithium heparin gel

Acceptable: Lithium heparin

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Lithium heparin gel tubes should be centrifuged within 2 hours of collection.

2. Plasma from lithium heparin tubes should be centrifuged and aliquoted within 2 hours of collection.


Forms

If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen. 

Useful For

Aiding in the exclusion of the diagnosis of acute coronary syndrome in a single plasma specimen

 

Aiding in the diagnosis of acute coronary syndrome

 

Monitoring acute coronary syndromes and estimating prognosis

 

Possible utility in monitoring patients with nonischemic causes of cardiac injury

Method Name

Electrochemiluminescent Immunoassay

Reporting Name

Troponin T, 5th gen, P

Specimen Type

Plasma Li Heparin

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma Li Heparin Frozen (preferred) 365 days
  Ambient  24 hours
  Refrigerated  24 hours

Clinical Information

Troponin T is a myofibrillar protein found in striated musculature. There are 2 types of myofilament: a thick filament containing myosin and a thin filament consisting of 3 different proteins, namely actin, tropomyosin, and troponin. Troponin is itself a complex of 3 protein subunits, which are termed troponin T, troponin I, and troponin C:

-Troponin T binds the troponin complex to tropomyosin

-Troponin I inhibits actomyosin ATPase in relation to the calcium concentration

-Troponin C has 4 binding sites for calcium and mediates calcium dependency

 

Troponin T is found in free cytosol and structurally bound protein. The unbound pool of troponin T is the source of early protein release in myocardial damage. Troponin T is released from the structural elements at a later stage, corresponding to the degradation of myofibrils that occurs in irreversible myocardial damage. Troponin T becomes elevated 2 to 4 hours after the onset of myocardial necrosis and can remain elevated for up to 14 days, or even longer on occasion.

 

The most common cause of cardiac injury is myocardial ischemia, ie, acute myocardial infarction. These patients are known to have an adverse short- and long-term prognosis compared to patients with unstable angina and no elevation of troponin T. Many of these patients, especially those with troponin T elevations above 30 ng/L, benefit from an aggressive strategy with anticoagulation and an invasive interventional strategy.

Reference Values

Males: ≤15 ng/L

Females: ≤10 ng/L

Interpretation

Values for healthy adults, based upon available literature and clinical guidelines, are 10 ng/L or less for women and 15 ng/L or less for men.

 

For patients who present with suspected acute coronary syndromes, troponin T values greater than the reference interval with a rising (≥10 ng/L over 2 hours or ≥12 ng/L over 6 hours) pattern are highly suggestive of acute cardiac injury. Decreasing values are indicative of recent cardiac injury. Serial measurement is highly recommended for the diagnosis or exclusion of acute coronary syndromes.

 

Troponin T values greater than the reference interval are associated with adverse events in patients with ischemic heart disease and many other clinical situations. Clinical judgment is necessary to distinguish patients who have ischemic heart disease from those who do not.

Clinical Reference

1. Sandoval Y, Jaffe AS: Using High-Sensitivity Cardiac Troponin T for Acute Cardiac Care. Am J Med 2017 Dec;130(12):1358-1365

2. Reichlin T, Cullen L, Parsonage WA, et al: Two-hour algorithm for triage toward rule-out and rule-in of acute myocardial infarction using high-sensitivity cardiac troponin T. Am J Med 2015 Apr;128(4):369-379

3. Gunsolus IL, Jaffe AS, Sexter A, et al: Sex-specific 99th percentiles derived from the AACC Universal Sample Bank for the Roche Gen 5 cTnT assay: Comorbidities and statistical methods influence derivation of reference limits. Clin Biochem 2017 Dec;50(18):1073-1077

Day(s) and Time(s) Performed

Monday through Sunday; Continuously

Analytic Time

Same day/1 day

Test Classification

This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

84484

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TRPS Troponin T, 5th gen, P 67151-1

 

Result ID Test Result Name Result LOINC Value
TRPS Troponin T, 5th gen, P 67151-1
Mayo Clinic Laboratories | Cardiology Catalog Additional Information:

mml-heart-failure