“High-sensitivity cardiac troponins in health and disease”

Faculty of Health, Medicine and Life Sciences

Supervisor:

• prof.dr. M.P. van Dieijen-Visser;
• prof.dr. L. v. Loon

Co-supervisor:

• dr. S.J.R. Meex

Diagnosing acute myocardial infarctions has improved thanks to a highly sensitive method of measuring a cardiac-specific protein (troponin T or I) in the blood. This method also makes it possible to measure troponin levels in healthy individuals. A disadvantage is that elevated troponin levels may be observed in individuals without an infarction as well. This dissertation found that troponin T exhibits a circadian rhythm in clinically stable individuals with elevated troponin levels. These fluctuations are significant enough to exceed the cut-off value for infarctions. The average clinical relevance is therefore limited and the circadian rhythm may offer an explanation for individual patients whose symptoms do not correspond to the troponin T concentrations. In the case of troponin I, no circadian rhythm was observed. Troponin may be a valuable mortality predictor in healthy individuals. That said, troponin T has better predictive values than troponin I. In the case of endurance sports, there appears to be a difference between the release of troponin during a myocardial infarction and when practicing an endurance sport. 

Keywords:

troponin, myocardial infarction, circadian rhythm, prediction, endurance sport