The troponin protein complex plays a key role in the regulation of cardiac muscle contractions. Prolonged ischemia of the myocardium can lead to death of cardiomyocytes and release of intracellular proteins, such as troponins, into circulation. For this reason, Troponin T levels exceeding the 99th percentile of a normal reference population are designated as the decision level for the diagnosis of an MI in conjunction with that patient’s clinical presentation. The development of high-sensitivity assays allows for lower levels of cardiac troponins to be assessed for other etiologies. Literature shows that even minimal increases of troponin levels are associated with unfavorable cardiovascular and all-cause mortality outcomes. This association is also independent of conventional risk factors.
Troponin T, High Sensitivity (hs-TnT) is an independent prognostic marker that aids in the diagnosis of myocardial infarction (MI) in an acute setting (>22 ng/L for males and >14 ng/L for females), and there is literature supporting its use to assess relative risk for cardiovascular disease (CVD) and adverse cardiovascular events (≥6 ng/L for males and females).
- In a review of more than 154,000 patients in the general population, detectable troponin concentrations below the diagnostic threshold for myocardial infarction (MI) were associated with increased relative risk of CVD, as well as death secondary to CHD and stroke.
- Several trials, comprised of generally healthy individuals (ARIC, CHS, DHS, and MESA), demonstrate that any detectable level ≥6 ng/L confers increased relative risk for CVD.6-9
- hs-TnT levels can help identify and stratify disease severity in patients, without history of diagnosed CAD, presenting to the outpatient department with angina.
- In a meta-analysis of general population studies, elevated hs-TnT was strongly associated with an increased relative risk of cardiovascular and all-cause mortality.
- Increased hs-TnT within a 6-year follow-up was independently associated with incident CHD, death, and HF, while decreases were associated with reduced risk of the same outcomes.
- In patients with chronic heart failure, hs-TnT is a strong and independent predictor of all-cause and cardiovascular mortality, and of hospitalization for cardiovascular causes.
References:
1. Katrukha IA. Human cardiac troponin complex. Structure and functions. Biochemistry Mosc. 2013;78(13):1447-1465.
2. Thygesen K, Alpert JS, Jaffe AS, et al. Third universal definition of myocardial infarction. Circulation. 2012;126(16):2020-2035.
3. Roche Diagnostics. Elecsys® Troponin T Gen 5 STAT. 2019-01, V 3.0.
4. Van der linden N, Klinkenberg LJ, Bekers O, et al. Prognostic value of basal highsensitive cardiac troponin levels on mortality in the general population: a meta-analysis. Medicine (Baltimore). 2016;95(52):e5703.
5. Willeit P, van Welsh P, Evans JDW, et al. High-sensitivity cardiac troponin concentration and risk of first-ever cardiovascular outcomes in 154,052 participants. J Am Coll Cardiol. 2017;70(5):558-568.
6. Oluleye OW, Folsom AR, Nambi V, et al. Troponin T, B-type natriuretic peptide, C-reactive protein, and cause-specific mortality. Ann Epidemiol. 2013;23(2):66-73.
7. deFilippi CR, de Lemos JA, Christenson RH, et al. Association of serial measures of cardiac troponin T using a sensitive assay with incident heart failure and cardiovascular mortality in older adults. JAMA. 2010;304(22):2494-2502.
8. de Lemos JA, Drazner MH, Omland T, et al. Association of troponin T detected with a highly sensitive assay and cardiac structure and mortality risk in the general population. JAMA. 2010;304(22):2503-2512.
9. Seliger SL, Hong SN, Christenson RH, et al. High-sensitive cardiac troponin T as an early biochemical signature for clinical and subclinical heart failure: MESA (Multi-Ethnic Study of Atherosclerosis). Circulation. 2017;135(16):1494-1505.
10. Laufer EM, Mingels AM, Winkens MH, et al. The extent of coronary atherosclerosis is associated with increasing circulating levels of high sensitive cardiac troponin T. Arterioscler Thromb Vasc Biol. 2010;30(6):1269-1275.
11. Mingels AM, Joosen IA, Versteylen MO, et al. High-sensitivity cardiac troponin T: risk stratification tool in patients with symptoms of chest discomfort. PLoS ONE. 2012;7(4):e35059.
12. McEvoy JW, Chen Y, Ndumele CE, et al. Six-year change in high-sensitivity cardiac troponin T and risk of subsequent coronary heart disease, heart failure, and death. JAMA Cardiol. 2016;1(5):519-528.
13. Aimo A, Januzzi JL, Vergaro G, et al. Prognostic value of high-sensitivity troponin T in chronic heart failure: an individual patient data meta-analysis. Circulation. 2018;137(3):286-297.
14. Scherr J, Braun S, Schuster T, et al. 72-h kinetics of high-sensitive troponin T and inflammatory markers after marathon. Med Sci Sports Exerc. 2011;43(10):1819-1827.
15. Sedaghat-Hamedani F, Kayvanpour E, Frankenstein L, et al. Biomarker changes after strenuous exercise can mimic pulmonary embolism and cardiac injury--a metaanalysis of 45 studies. Clin Chem. 2015;61(10):1246-1255.
16. Nadruz W, Gonçalves A, Claggett B, et al. Influence of cigarette smoking on cardiac biomarkers: the Atherosclerosis Risk in Communities (ARIC) Study. Eur J Heart Fail. 2016;18(6):629-637.
17. Qamar A, Giugliano RP, Bohula EA, et al. Biomarkers and clinical cardiovascular outcomes with ezetimibe in the IMPROVE-IT trial. J Am Coll Cardiol. 2019;74(8):1057-1068.
18. Third report of the National Cholesterol Education Program (NCEP). Expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). National Institutes of Health. September 2002. NIH Publication No. 02-5215.
19. Whelton SP, Mcevoy JW, Lazo M, Coresh J, Ballantyne CM, Selvin E. Highsensitivity cardiac troponin T (hs-cTnT) as a predictor of incident diabetes in the atherosclerosis risk in communities study. Diabetes Care. 2017;40(2):261-269.
20. American Diabetes Association: standards of medical care in diabetes-2018. Diabetes Care. 2018;41(Supplement 1).
21. McEvoy JW, Chen Y, Nambi V, et al. High-sensitivity cardiac troponin T and risk of hypertension. Circulation. 2015;132(9):825-833.
22. Neukamm AM, Høiseth AD, Hagve TA, Søyseth V, Omland T. High-sensitivity cardiac troponin T levels are increased in stable COPD. Heart. 2013;99(6):382-387.
23. Høiseth AD, Neukamm A, Karlsson BD, Omland T, Brekke PH, Søyseth V. Elevated high-sensitivity cardiac troponin T is associated with increased mortality after acute exacerbation of chronic obstructive pulmonary disease. Thorax. 2011;66(9):775- 781.
24. Yancy CW, Jessup M, Bozkurt B., et al. 217 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure. J Am Coll Cardiol. 2017; 70 (6): 776-803.
Your medical lab tests hold vital information about your health. Our tools help you understand what's going on and how to take action.
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A troponin test measures the level of troponin in your blood. Troponin is a type of protein found in the muscles of your heart. Troponin isn't normally found in the blood. When heart muscles become damaged, troponin is sent into the bloodstream. As heart damage increases, greater amounts of troponin are released in the blood.
Treatment Considerations:
(The treatment considerations are provided for informational purposes only and are not intended as medical advice. A physician’s test selection and interpretation, diagnosis, and patient management decisions should be based on his/her education, clinical expertise, and assessment of the patient.)
Assess level of exercise.
hs-TnT levels may be elevated in marathon runners and other athletes following strenuous exercise.
Assess smoking habits.
Smoking cessation is essential, as individuals who smoke are at increased risk of heart disease and blood clots.
Assess LDL-C levels.
If not at an optimal level, consider lipid-lowering therapies described in the National Cholesterol Education Program/Adult Treatment Panel III (NCEP ATP III) Guidelines.
Assess insulin sensitivity.
If not at an optimal level, consider insulin-sensitizing therapies described in the ADA guidelines for the management of pre-diabetes/diabetes.
Assess blood pressure.
If not at an optimal level, consider initiating, or titrating, antihypertensive therapy. Assess the presence of coronary artery disease (CAD) with imaging techniques such as carotid intima media thickness testing (CIMT) or coronary artery calcium (CAC) scoring.
Assess the presence of coronary artery disease (CAD) with imaging techniques such as carotid intima media thickness testing (CIMT) or coronary artery calcium (CAC) scoring.
Assess presence of chronic obstructive pulmonary disease (COPD).
COPD may lead to hypoxia and tachycardia, resulting in subclinical myocardial damage and hs-TnT elevations.
Assess for heart failure.
If heart failure is present or suspected, reference the American College of Cardiology/American Heart Association/Heart Failure Society of America (ACC/AHA/ HFSA) guidelines for management of heart failure.
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Unlimited Plan Member since 2021
I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
Healthmatters is a highly-personalized health dashboard.
Instead of searching for your lab results in different places or tracking them down from different providers, Healthmatters houses, organizes, and interprets them all in one central location.
With a Healthmatters account, you can dive into the details of each biomarker and gain insights into the meaning behind your medical test data, anytime, anywhere.
For our professional users, Healthmatters provides intuitive tools that not only streamline analysis but also save valuable time when delving into your client's lab report history.
Healthmatters.io personal account provides in-depth research on 4000+ biomarkers, including information and suggestions for test panels such as, but not limited to:
You can combine all test reports inside your Healthmatters account and keep them in one place. It gives you an excellent overview of all your health data. Once you retest, you can add new results and compare them.
If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.
While we work with many popular labs, we welcome reports from lots of other places too.
It's as simple as this: if you can get a test done, you can upload it to Healthmatters and we can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
If you’re on the hunt for a specific biomarker, contact us and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account.
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For those who prefer assistance, we offer a "Data entry service" to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you.
We support various file types, including PDFs, JPGs, or Excel. This service is particularly useful if you have many reports to upload or if you're too busy to handle the data entry yourself.
Our special data entry service makes it easy to add your results to your private dashboard. Just attach an image or a file of your lab test results, and our skilled data entry team will do the work for you. It's all done by humans, ensuring that your data is entered accurately and with personal care for each client.
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Additionally, you can upgrade to the yearly Advanced plan from within your account. The annual cost is $79, and it comes with a data entry service for five reports.
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Simply log in and navigate to your account settings to cancel your subscription. Scroll down to locate the 'Cancel' button at the bottom of the page. Ensure you cancel at least one day before the renewal date to prevent any charges. Once cancellation is requested, the subscription remains active until the conclusion of the current billing cycle.
Our goal has been to make your Healthmatters account as intuitive as possible.
We’ve crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into your historical test reports.
1. Graph View:Dive into a visual journey with our biomarker graphs, showcasing over 40 data points. Combining years of results unveils trends, empowering you to make informed decisions. Our visualization tools make it a breeze to compare and understand changes over time, even if your results are from different labs. A search function and filters simplify the exploration of extensive data, allowing you to focus on what needs attention.
2. All Tests ViewExplore neatly organized reports on a timeline, highlighting crucial details like dates, critical results, and lab/panel names. Each report opens up to reveal in-depth descriptions and additional recommendations for each biomarker. The history of previous results is just a click away, and you can download a comprehensive report for deeper insights. Color-coded and user-friendly, it's designed for easy reading, understanding, and navigation.
3. Table View:For a holistic view of all biomarkers side by side, our table view is your go-to. Results are neatly displayed in a categorized and dated table, ideal for those with an extensive test history. Utilize sorting, filters, and color-coding to enhance your analysis and gain extra insights.
Yes, you can download information from your account. We can compile your labs into a CSV file. To download all your labs, you can go to Account Settings, and at the bottom of the page, you will find a link to download your information.
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Yes, you can! We highly recommend activating Two-Factor Authentication (2FA) for your account. To do so, please navigate to the "Profile and Security" section of your account, where you will find instructions for activating 2FA.
Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.
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