Multiple molecular forms of circulating cardiac troponin: analytical and clinical significance

Ann Clin Biochem 2008;45:349-355
© 2008 Association for Clinical Biochemistry


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Review Article

David C Gaze and
Paul O Collinson

Chemical Pathology, St George’s Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK

Corresponding author: Dr David Gaze. Email: david.gaze{at}

Cardiac troponin T (cTnT) and I (cTnI) are highly specific andsensitive biomarkers of myocardial cell damage and are now acceptedas the ‘gold standard’ diagnostic test for acutecoronary syndrome and supersede the classical muscle enzymebiomarkers. While the understanding of the development and structureof the troponins has advanced, detailed biochemistry of thetroponin molecules is complex and poorly understood. Many post-translationalmolecular forms of troponin are known to exist. The diversityof these circulating forms may have a clinical impact and thenotion of a disease-specific troponin protein signature hasbeen suggested. However, the effects of these multiple formson commercial assay performance and their impact clinicallyare currently unknown and should be the focus of future researchand assay design.

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