Medical expert of the article
New publications
Causes of elevated troponin T
Last reviewed: 06.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Troponin T concentration increases after the onset of myocardial infarction to a much greater extent than CK and LDH activity. In some patients with successful recanalization, troponin T concentration may increase more than 300-fold. Troponin T concentration in the blood depends on the size of the myocardial infarction. Thus, in large-focal or transmural myocardial infarction after thrombolysis, troponin T concentration may increase up to 400-fold, and in patients with non-Q-wave myocardial infarction - only 37-fold. The time of maintaining a high concentration of troponin T in the blood serum is also significantly longer than CK and LDH. A long period of troponin T release into the blood increases the probability that a positive result of its determination was correct, especially in the subacute phase of myocardial infarction. The "diagnostic window" (the time during which altered values of the studied parameter are detected in pathological conditions) for troponin T is 4 times greater than for CK and 2 times greater than for LDH. The interval of absolute diagnostic sensitivity in acute myocardial infarction for troponin T is 125-129 hours, for CK and LDH - 22 and 70 hours, respectively.
Serum troponin T concentration increases in patients after cardiac surgery. In heart transplantation, troponin T concentration increases to 3-5 ng/ml and remains elevated for 70-90 days.
Non-coronary diseases and damage to the heart muscle (myocarditis, heart trauma, cardioversion) can also be accompanied by an increase in the concentration of troponin T in the blood, but the dynamics of its change, characteristic of myocardial infarction, are absent.
Serum troponin T levels may increase in septic shock and during chemotherapy due to toxic myocardial damage.
False positive results in the determination of troponin T in blood serum can be obtained in the presence of hemolysis (interference), in patients with a significant increase in the concentration of Ig in the blood, acute renal failure and especially chronic renal failure, as well as in chronic muscle pathology.
An increase in the concentration of troponin T is possible with acute alcohol intoxication, but this is not observed with chronic intoxication.
Slightly elevated serum troponin T levels are found in 15% of patients with severe skeletal muscle damage (CK-MB activity increases in 50% of such patients), so troponin T can be considered a highly specific marker of MI even in the presence of skeletal muscle damage.
Unlike cardiac troponin, skeletal muscles express muscle troponin T. Despite the fact that cardiac troponin T is determined using specific monoclonal antibodies, cross-reactions occur when large amounts of troponin T are received from skeletal muscles.
In patients with troponin T concentration of 0.1-0.2 ng/ml, the risk of early complications is especially high, so in such cases active therapy and careful monitoring over time are necessary. Since only the quantitative method for determining troponin T allows measuring concentrations within 0.1-0.2 ng/ml, this study has an advantage over the rapid qualitative method, the sensitivity threshold of which is 0.2 ng/ml.