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  • During contraction of muscle-thick filaments of myosin slide past thin filaments of actin by calcium mediated atp dependent contraction
    • Released calcium binds to troponin C, T, and I, which regulate muscle contraction
  • Troponins do not change in trauma, skeletal muscle disease, exercise
  • Troponin C found in all tissue and is not cardiac marker
  • Troponin T is qualitative assay
  • Troponin I is quantitative assay
  • High sensitivity troponin T (hsTnT) is a quantitative assay

Cardiac Enzymes Over Time

Type Interval Peak Elevation Return to Normal
Myoglobin 1-4h 6-7h 18-24h
Troponin I 3-12 10-24 3-10d
Troponin T 3-12 10-24 5-14d
CK-MB 4-12 12-24 48-72
LDH 8-12 24-48 10-14d

Differential Diagnosis

Elevated Troponin

True Positive

False (Non-CAD) Positives

See Also

External Links