Document Detail

Circulating cardiac troponin T exhibits a diurnal rhythm.
MedLine Citation:
PMID:  24583293     Owner:  NLM     Status:  Publisher    
OBJECTIVES: To test the unverified assumption that chronically elevated cardiac troponin T (cTnT) levels fluctuate randomly around a homeostatic setpoint.
BACKGROUND: The introduction of high-sensitivity cTn assays has improved sensitivity for acute myocardial infarction (AMI). However, many patients with a single positive cTn test have in fact no AMI. Therefore, the diagnosis of AMI relies strongly on serial testing and interpretation of cTn kinetics. Essential in this regard is a profound understanding of the biological variation of cTn.
METHODS: Two studies were conducted to assess biological cTnT variation, and investigate the presence of a diurnal rhythm of cTnT. Study 1 comprised 23 male subjects with type 2 diabetes, without acute cardiovascular disease. Serial venous blood samples were drawn over an 11h period (08:30-19:30h). In study 2, presence of a diurnal cTnT rhythm was investigated by hourly sampling of 7 subjects from study 1 over 25h.
RESULTS: In study 1, we observed a gradual decrease in cTnT concentrations during the day (24±2%). This decrease was present in all participants and most prominent in subjects with the highest baseline cTnT values (Pearson's R 0.93). Diurnal variation of cTnT, as assessed in study 2, was characterized by peak concentrations during morning hours (08:30h,17.1±2.9ng/L), gradually decreasing values during daytime (20:30h,11.9±1.6ng/L), and rising concentrations during nighttime (08:30h next day,16.9±2.8ng/L).
CONCLUSIONS: A diurnal cTnT rhythm substantiates the recommendation that all dynamic changes of cTnT should be interpreted in relation to the clinical presentation. Epidemiological studies and risk-stratification protocols using cTnT may benefit from standardized sampling times.
Lieke J J Klinkenberg; Jan-Willem van Dijk; Frans E S Tan; Luc J C van Loon; Marja P van Dieijen-Visser; Steven J R Meex
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-2-13
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  -     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-3-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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