Half-Life and Clearance of Cardiac Troponin I and Troponin T in Humans.

IF 35.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation Pub Date : 2024-09-10 DOI:10.1161/circulationaha.123.066565

Jonas Henrik Kristensen,Rasmus Bo Hasselbalch,Nina Strandkjær,Nicoline Jørgensen,Morten Østergaard,Peter Hasse Møller-Sørensen,Jens Christian Nilsson,Shoaib Afzal,Pia Rørbæk Kamstrup,Morten Dahl,Mustafa Vakur Bor,Ruth Frikke-Schmidt,Niklas Rye Jørgensen,Line Rode,Lene Holmvang,Jesper Kjærgaard,Lia Evi Bang,Julie Forman,Kim Dalhoff,Allan S Jaffe,Kristian Thygesen,Henning Bundgaard,Kasper Karmark Iversen

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引用次数: 0

Abstract

BACKGROUND Cardiac troponin (cTn) is key in diagnosing myocardial infarction (MI). After MI, the clinically observed half-life of cTn has been reported to be 7 to 20 hours, but this estimate reflects the combined elimination and simultaneous release of cTn from cardiomyocytes. More precise timing of myocardial injuries necessitates separation of these 2 components. We used a novel method for determination of isolated cTn elimination kinetics in humans. METHODS Patients with MI were included within 24 hours after revascularization and underwent plasmapheresis to obtain plasma with a high cTn concentration. After at least 3 weeks, patients returned for an autologous plasma retransfusion followed by blood sampling for 8 hours. cTn was measured with 5 different high-sensitivity cTn assays. RESULTS Of 25 included patients, 20 participants (mean age, 64.5 years; SD, 8.2 years; 4 women [20%]) received a retransfusion after a median of 5.8 weeks (interquartile range, 5.0-6.9 weeks) after MI. After retransfusion of a median of 620 mL (range, 180-679 mL) autologous plasma, the concentration of cTn in participants' blood increased 4 to 445 times above the upper reference level of the 5 high-sensitivity cTn assays. The median elimination half-life ranged from 134.1 minutes (95% CI, 117.8-168.0) for the Elecsys high-sensitivity cTnT assay to 239.7 minutes (95% CI, 153.7-295.1) for the Vitros high-sensitivity cTnI assay. The median clearance of cTnI ranged from 40.3 mL/min (95% CI, 32.0-44.9) to 52.7 mL/min (95% CI, 42.2-57.8). The clearance of cTnT was 77.0 mL/min (95% CI, 45.2-95.0). CONCLUSIONS This novel method showed that the elimination half-life of cTnI and cTnT was 5 to 16 hours shorter than previously reported. This indicates a considerably longer duration of cardiomyocyte cTn release after MI than previously thought. Improved knowledge of timing of myocardial injury may call for changes in the management of MI and other disorders with myocardial injury.

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人体心肌肌钙蛋白 I 和肌钙蛋白 T 的半衰期和清除率

背景心肌肌钙蛋白（cTn）是诊断心肌梗死（MI）的关键。据报道，心肌梗死后，临床观察到的 cTn 半衰期为 7 到 20 小时，但这一估计值反映了 cTn 从心肌细胞中消除和同时释放的综合情况。要更精确地确定心肌损伤的时间，就必须将这两种成分分开。我们采用了一种新方法来测定人体分离的 cTn 消除动力学。方法在血管再通后 24 小时内纳入心肌梗死患者，并进行血浆分离以获得高浓度 cTn 血浆。结果在纳入的 25 名患者中，有 20 名患者（平均年龄 64.5 岁；SD 为 8.2 岁；4 名女性 [20%]）在心肌梗死后中位数 5.8 周（四分位间范围为 5.0-6.9 周）后接受了再输血。在再次输注中位数为 620 毫升（范围为 180-679 毫升）的自体血浆后，参与者血液中的 cTn 浓度比 5 种高灵敏度 cTn 检测方法的最高参考水平高出 4-445 倍。Elecsys高灵敏度cTnT测定的中位消除半衰期为134.1分钟（95% CI，117.8-168.0），Vitros高灵敏度cTnI测定的中位消除半衰期为239.7分钟（95% CI，153.7-295.1）。cTnI 的中位清除率从 40.3 毫升/分钟（95% CI，32.0-44.9）到 52.7 毫升/分钟（95% CI，42.2-57.8）不等。结论：这种新方法显示，cTnI 和 cTnT 的消除半衰期比以前报道的短 5 到 16 小时。这表明心肌梗死后心肌细胞 cTn 释放的持续时间比以前认为的要长很多。对心肌损伤时间的进一步了解可能会改变心肌梗死和其他心肌损伤疾病的治疗方法。

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来源期刊

Circulation 医学-外周血管病

CiteScore

45.70

自引率

2.10%

发文量

1473

审稿时长

2 months

期刊介绍： Circulation is a platform that publishes a diverse range of content related to cardiovascular health and disease. This includes original research manuscripts, review articles, and other contributions spanning observational studies, clinical trials, epidemiology, health services, outcomes studies, and advancements in basic and translational research. The journal serves as a vital resource for professionals and researchers in the field of cardiovascular health, providing a comprehensive platform for disseminating knowledge and fostering advancements in the understanding and management of cardiovascular issues.