Circadian rhythm of cardiac troponins. Does it really exist?

Abstract

According to the third universal definition of myocardial infarction, biomarkers and especially troponin plays a central role in the early diagnosis of acute myocardial infarction (AMI) [ [1] Thygesen K. Alpert J.S. Jaffe A.S. Simoons M.L. Chaitman B.R. White H.D. et al. Third universal definition of myocardial infarction. Eur. Heart J. 2012; 33: 2551-2567 Crossref PubMed Scopus (2230) Google Scholar ]. High-sensitivity cardiac troponin (hs-cTn) is the preferred biomarker to establish the diagnosis in patients presenting without persistent ST-segment elevation Acute Coronary Syndromes (ACS) [ [2] Roffi M. Patrono C. Collet J.P. Mueller C. Valgimigli M. Andreotti F. et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur. Heart J. 2016; 37: 267-315 Crossref PubMed Scopus (4315) Google Scholar ] and detection of a rise and/or fall of cTn values with at least one value above the 99th percentile upper reference limit (URL) in conjunction with clinical and electrocardiographic characteristics could lead to the diagnosis of AMI [ [1] Thygesen K. Alpert J.S. Jaffe A.S. Simoons M.L. Chaitman B.R. White H.D. et al. Third universal definition of myocardial infarction. Eur. Heart J. 2012; 33: 2551-2567 Crossref PubMed Scopus (2230) Google Scholar , [2] Roffi M. Patrono C. Collet J.P. Mueller C. Valgimigli M. Andreotti F. et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur. Heart J. 2016; 37: 267-315 Crossref PubMed Scopus (4315) Google Scholar ]. Circadian rhythm of cardiac troponin I and its clinical impact on the diagnostic accuracy for acute myocardial infarctionInternational Journal of CardiologyVol. 270PreviewHigh-sensitivity cardiac troponin T (hs-cTnT) blood concentrations were shown to exhibit a diurnal rhythm, characterized by gradually decreasing concentrations throughout daytime, rising concentrations during nighttime and peak concentrations in the morning. We aimed to investigate whether this also applies to (h)s-cTnI assays and whether it would affect diagnostic accuracy for acute myocardial infarction (AMI). Full-Text PDF