TY - JOUR
T1 - Half-Life and Clearance of Cardiac Troponin I and Troponin T in Humans
AU - Kristensen, Jonas Henrik
AU - Hasselbalch, Rasmus Bo
AU - Strandkjær, Nina
AU - Jørgensen, Nicoline
AU - Østergaard, Morten
AU - Møller-Sørensen, Peter Hasse
AU - Nilsson, Jens Christian
AU - Afzal, Shoaib
AU - Kamstrup, Pia Rørbæk
AU - Dahl, Morten
AU - Bor, Mustafa Vakur
AU - Frikke-Schmidt, Ruth
AU - Jørgensen, Niklas Rye
AU - Rode, Line
AU - Holmvang, Lene
AU - Kjærgaard, Jesper
AU - Bang, Lia Evi
AU - Forman, Julie
AU - Dalhoff, Kim
AU - Jaffe, Allan S
AU - Thygesen, Kristian
AU - Bundgaard, Henning
AU - Iversen, Kasper Karmark
PY - 2024/10/8
Y1 - 2024/10/8
N2 - BACKGROUND: Cardiac troponin (cTn) is key in diagnosing myocardial infarction (MI). After MI, the clinically observed half-life of cTn has been reported to be 7 to 20 hours, but this estimate reflects the combined elimination and simultaneous release of cTn from cardiomyocytes. More precise timing of myocardial injuries necessitates separation of these 2 components. We used a novel method for determination of isolated cTn elimination kinetics in humans.METHODS: Patients with MI were included within 24 hours after revascularization and underwent plasmapheresis to obtain plasma with a high cTn concentration. After at least 3 weeks, patients returned for an autologous plasma retransfusion followed by blood sampling for 8 hours. cTn was measured with 5 different high-sensitivity cTn assays.RESULTS: Of 25 included patients, 20 participants (mean age, 64.5 years; SD, 8.2 years; 4 women [20%]) received a retransfusion after a median of 5.8 weeks (interquartile range, 5.0-6.9 weeks) after MI. After retransfusion of a median of 620 mL (range, 180-679 mL) autologous plasma, the concentration of cTn in participants' blood increased 4 to 445 times above the upper reference level of the 5 high-sensitivity cTn assays. The median elimination half-life ranged from 134.1 minutes (95% CI, 117.8-168.0) for the Elecsys high-sensitivity cTnT assay to 239.7 minutes (95% CI, 153.7-295.1) for the Vitros high-sensitivity cTnI assay. The median clearance of cTnI ranged from 40.3 mL/min (95% CI, 32.0-44.9) to 52.7 mL/min (95% CI, 42.2-57.8). The clearance of cTnT was 77.0 mL/min (95% CI, 45.2-95.0).CONCLUSIONS: This novel method showed that the elimination half-life of cTnI and cTnT was 5 to 16 hours shorter than previously reported. This indicates a considerably longer duration of cardiomyocyte cTn release after MI than previously thought. Improved knowledge of timing of myocardial injury may call for changes in the management of MI and other disorders with myocardial injury.
AB - BACKGROUND: Cardiac troponin (cTn) is key in diagnosing myocardial infarction (MI). After MI, the clinically observed half-life of cTn has been reported to be 7 to 20 hours, but this estimate reflects the combined elimination and simultaneous release of cTn from cardiomyocytes. More precise timing of myocardial injuries necessitates separation of these 2 components. We used a novel method for determination of isolated cTn elimination kinetics in humans.METHODS: Patients with MI were included within 24 hours after revascularization and underwent plasmapheresis to obtain plasma with a high cTn concentration. After at least 3 weeks, patients returned for an autologous plasma retransfusion followed by blood sampling for 8 hours. cTn was measured with 5 different high-sensitivity cTn assays.RESULTS: Of 25 included patients, 20 participants (mean age, 64.5 years; SD, 8.2 years; 4 women [20%]) received a retransfusion after a median of 5.8 weeks (interquartile range, 5.0-6.9 weeks) after MI. After retransfusion of a median of 620 mL (range, 180-679 mL) autologous plasma, the concentration of cTn in participants' blood increased 4 to 445 times above the upper reference level of the 5 high-sensitivity cTn assays. The median elimination half-life ranged from 134.1 minutes (95% CI, 117.8-168.0) for the Elecsys high-sensitivity cTnT assay to 239.7 minutes (95% CI, 153.7-295.1) for the Vitros high-sensitivity cTnI assay. The median clearance of cTnI ranged from 40.3 mL/min (95% CI, 32.0-44.9) to 52.7 mL/min (95% CI, 42.2-57.8). The clearance of cTnT was 77.0 mL/min (95% CI, 45.2-95.0).CONCLUSIONS: This novel method showed that the elimination half-life of cTnI and cTnT was 5 to 16 hours shorter than previously reported. This indicates a considerably longer duration of cardiomyocyte cTn release after MI than previously thought. Improved knowledge of timing of myocardial injury may call for changes in the management of MI and other disorders with myocardial injury.
KW - Aged
KW - Biomarkers/blood
KW - Female
KW - Half-Life
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/blood
KW - Plasmapheresis
KW - Troponin I/blood
KW - Troponin T/blood
UR - http://www.scopus.com/inward/record.url?scp=85204205467&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.123.066565
DO - 10.1161/CIRCULATIONAHA.123.066565
M3 - Journal article
C2 - 39253802
SN - 0009-7322
VL - 150
SP - 1187
EP - 1198
JO - Circulation
JF - Circulation
IS - 15
ER -