The journal of applied laboratory medicine · 2026
The Half-Life of Long Forms of Cardiac Troponin T.
СтатьяНазвание и аннотация: Перевод в очереди
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Hasselbalch Rasmus Bo, Salonen Selma, Kristensen Jonas Henrik, Tuominen Tuulia, Strandkjær Nina, Østergaard Morten, Møller-Sørensen Hasse, Nilsson Jens Christian, Dahl Morten, Bor Mustafa Vakur, Frikke-Schmidt Ruth, Jørgensen Niklas Rye, Rode Line, Holmvang Lene, Kjærgaard Jesper, Bang Lia E, Forman Julie, Dalhoff Kim P, Jaffe Allan S, Thygesen Kristian, Bundgaard Henning, Wittfooth Saara, Iversen Kasper Karmark
Аннотация
BACKGROUND: Long forms of cardiac troponin T (cTnT) are promising markers that may differentiate myocardial infarction from other causes of acute and chronic myocardial injury. However, to understand the clinical utility of long cTnT, knowledge of the half-life (T½) is key. By using auto-transfusion in humans we determined the T½ of long forms of cTnT and compared long cTnT to a commercial high-sensitivity total cTnT assay.
METHODS: Patients with ST-segment-elevation-myocardial infarction were included within 24 h after revascularization and underwent plasmapheresis to obtain plasma with a high cTnT concentration. After at least 3 weeks, patients returned for an autologous plasma re-transfusion followed by repeated blood sampling. A novel assay measured long cTnT and a commercially available assay measured total cTnT.
RESULTS: We included 17 patients with median age 63 years (25th-75th percentiles 59-70), and 4 (24%) were female. The median concentrations after transfusion were 99 ng/L (54-125) for long cTnT vs 252 ng/L (233-322) for total cTnT. The median ratio of long cTnT to total cTnT was 0.39 (0.26-0.55) after transfusion and declined to 0.30 (0.20-0.44) after 60 min. Long cTnT displayed a 2-phase exponential decay, similar to what was observed for total cTnT but with shorter T½ both for the distribution phase [16 min (11-18) vs 22 min (20-24), P < 0.001] and the elimination phase [103 min (78-125) vs 133 min (114-168), P < 0.001].
CONCLUSION: The elimination of long forms of cTnT was faster than for total cTnT following re-transfusion. This understanding could aid in differentiating myocardial infarction from other causes of acute and chronic myocardial injury.
METHODS: Patients with ST-segment-elevation-myocardial infarction were included within 24 h after revascularization and underwent plasmapheresis to obtain plasma with a high cTnT concentration. After at least 3 weeks, patients returned for an autologous plasma re-transfusion followed by repeated blood sampling. A novel assay measured long cTnT and a commercially available assay measured total cTnT.
RESULTS: We included 17 patients with median age 63 years (25th-75th percentiles 59-70), and 4 (24%) were female. The median concentrations after transfusion were 99 ng/L (54-125) for long cTnT vs 252 ng/L (233-322) for total cTnT. The median ratio of long cTnT to total cTnT was 0.39 (0.26-0.55) after transfusion and declined to 0.30 (0.20-0.44) after 60 min. Long cTnT displayed a 2-phase exponential decay, similar to what was observed for total cTnT but with shorter T½ both for the distribution phase [16 min (11-18) vs 22 min (20-24), P < 0.001] and the elimination phase [103 min (78-125) vs 133 min (114-168), P < 0.001].
CONCLUSION: The elimination of long forms of cTnT was faster than for total cTnT following re-transfusion. This understanding could aid in differentiating myocardial infarction from other causes of acute and chronic myocardial injury.