Document Detail

Cardiac troponins and physical exercise. It's time to make a point.
MedLine Citation:
PMID:  22141208     Owner:  NLM     Status:  MEDLINE    
The timely diagnosis of acute coronary syndrome (ACS), in particular myocardial infarction (MI), is still one of the most challenging issues in medicine. The introduction into routine laboratory practice of assays for measuring the cardiospecific troponins has dramatically revolutionized the diagnostic approach and the recent development of methods with improved analytical sensibility (i.e., highly sensitivity [HS] assays), has further contributed to improve the negative predictive value of troponin testing but, contextually, has substantially lowered the clinical specificity of these markers. In particular, clinical studies have demonstrated the existence of an exercise-related increase of HS-troponins, with measurable values detectable in up to 94% of athletes undergoing endurance sports. This measurable amount oftroponin in blood would mirror an increased membrane permeability and early troponin release rather than reflecting a clinically threatening myocardial injury. As such, the measurable amount of cardiac troponins as assessed with the novel HS assays requires major clinical focus (i.e., serial measurement of cardiac biomarkers, detailed clinical history-taking, integration with ECG and imaging findings) to prevent misdiagnosis of ACS and/or MI in otherwise healthy persons.
Giuseppe Lippi; Gianfranco Cervellin; Giuseppe Banfi; Mario Plebani
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Biochemia medica     Volume:  21     ISSN:  1330-0962     ISO Abbreviation:  Biochem Med (Zagreb)     Publication Date:  2011  
Date Detail:
Created Date:  2011-12-06     Completed Date:  2012-01-10     Revised Date:  2013-07-31    
Medline Journal Info:
Nlm Unique ID:  9610305     Medline TA:  Biochem Med (Zagreb)     Country:  Croatia    
Other Details:
Languages:  eng     Pagination:  55-62     Citation Subset:  IM    
U.O. Diagnostica Ematochimica, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero-Universitaria di Parma, Italy.
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MeSH Terms
Acute Coronary Syndrome / blood,  diagnosis*
Biological Markers / blood*
Blood Chemical Analysis / methods,  standards
Myocardial Infarction / blood,  diagnosis*
Myocardium / metabolism*
Predictive Value of Tests
Sensitivity and Specificity
Troponin / blood*,  diagnostic use*
Reg. No./Substance:
0/Biological Markers; 0/Troponin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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