Diagnostic and Prognostic Performance of High-Sensitivity Cardiac Troponin T vs I

International practice guidelines consider high-sensitivity cardiac troponin (hs-cTn) T and I equivalent irrespective of the clinical indication. This assumption has recently been challenged by clinical and experimental studies suggesting possible differences between cTnT and cTnI, including a diurnal rhythm for cTnT but not cTnI, and a stronger association of hs-cTnT with renal function. Furthermore, differences regarding genetic loci, re-expression in skeletal muscle disease, macrotroponin, and heterophilic antibodies were described.

The clinical implications of these differences in the early diagnosis of myocardial infarction (MI) are incompletely understood as previous clinical studies directly comparing hs-cTnT with hs-cTnI had important methodologic limitations.

We therefore aimed to directly compare the diagnostic and prognostic performance of hs-cTnT vs hs-cTnI measured from the same blood sample in a large prospective diagnostic study that centrally adjudicated the final diagnosis of MI twice: once including serial measurements of hs-cTnT and once hs-cTnI, in addition to all available clinical information.