Experience with cardiac troponin T in difficult cases.

Abstract

Recent years have seen the advent of new cardiac markers. These have been shown to be valuable in large controlled clinical trials. The breakthrough of the troponins world-wide for detection of myocardial lesions has meant that the Cardiac Troponin T parameter has been available in our hospital since August 1996. Analysis of the samples is carried out on the Elecsys, an automated immunology analyzer from Roche Diagnostics, Austria. The purpose of the present paper is to investigate whether study results on the diagnostic utility, sensitivity and specificity of troponin T can be confirmed in multimorbid patients in routine clinical practice, who are otherwise excluded from such trials. Troponin T was investigated in five cases including patients presenting with myocarditis and parallel damage of the skeletal muscles, as well as in haemodialysis patients. Cardiac troponin T has proved to be a very reliable parameter in all of these patients due to its high sensitivity and specificity, where other conventional diagnostic procedures were not helpful due to co-morbidity and confounding factors. New clinically relevant information can be obtained by both individual as well as serial measurements. Cardiac troponin T determination is a powerful new tool and should be considered seriously, regardless of other underlying diseases: it is, therefore, not only a diagnostic but also a management tool.