1. Multi-Site Coronary Vein Sampling Study on Cardiac Troponin T Degradation in Non-ST-Segment-Elevation Myocardial Infarction: Toward a More Specific Cardiac Troponin T Assay
- Author
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Stephanie T. P. Mezger, Alma M.A. Mingels, Harry Suryapranata, Marc A. Brouwer, Otto Bekers, Sander A.J. Damen, Wim H. M. Vroemen, Niels van Royen, Freek W.A. Verheugt, Will K. W. H. Wodzig, Steven J.R. Meex, G. Etienne Cramer, Douwe de Boer, MUMC+: DA CDL Algemeen (9), RS: CARIM - R2.02 - Cardiomyopathy, Imaging Mass Spectrometry (IMS), RS: M4I - Imaging Mass Spectrometry (IMS), MUMC+: DA CDL Analytisch cluster 1K (9), Faculteit FHML Centraal, MUMC+: DA CDL Toegelatenen (9), RS: NUTRIM - R3 - Respiratory & Age-related Health, MUMC+: DA CDL (5), RS: Carim - H02 Cardiomyopathy, and ACS - Atherosclerosis & ischemic syndromes
- Subjects
Male ,BLOOD ,Myocardial Biology ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,ROOT CAUSE ,030204 cardiovascular system & hematology ,SERUM PREPARATION ,non ST-segment elevation acute coronary syndrome ,0302 clinical medicine ,Troponin complex ,THROMBIN ACTIVATION ,cardiac biomarkers ,ST segment ,Protein Isoforms ,Coronary Heart Disease ,030212 general & internal medicine ,Myocardial infarction ,Non-ST Elevated Myocardial Infarction ,Original Research ,cardiac troponin T degradation ,Blood Specimen Collection ,Multi site ,Coronary Sinus ,Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16] ,Middle Aged ,Coronary Vessels ,Cardiology ,Chromatography, Gel ,Female ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Cardiac troponin ,Cardiac biomarkers ,Blotting, Western ,03 medical and health sciences ,All institutes and research themes of the Radboud University Medical Center ,Troponin T ,Internal medicine ,medicine ,Humans ,Aged ,RELEASE ,non ST‐segment elevation acute coronary syndrome ,Coronary Vein ,business.industry ,Troponin I ,medicine.disease ,Peptide Fragments ,RENAL-DISEASE ,business ,Troponin C ,Biomarkers - Abstract
Background Cardiac troponin T ( cTnT ) is seen in many other conditions besides myocardial infarction, and recent studies demonstrated distinct forms of cTnT . At present, the in vivo formation of these different cTnT forms is incompletely understood. We therefore performed a study on the composition of cTnT during the course of myocardial infarction, including coronary venous system sampling, close to its site of release. Methods and Results Baseline samples were obtained from multiple coronary venous system locations, and a peripheral artery and vein in 71 non– ST ‐segment–elevation myocardial infarction patients. Additionally, peripheral blood was drawn at 6‐ and 12‐hours postcatheterization. cTnT concentrations were measured using the high‐sensitivity‐ cTnT immunoassay. The cTnT composition was determined via gel filtration chromatography and Western blotting in an early and late presenting patient. High‐sensitivity ‐ cTnT concentrations were 28% higher in the coronary venous system than peripherally (n=71, P cT n T‐I‐C complex, free intact cTnT , and 29 kD a and 15 to 18 kD a cTnT fragments, all in higher concentrations than in simultaneously obtained peripheral samples. While cT n T‐I‐C complex proportionally decreased, and disappeared over time, 15 to 18 kD a cTnT fragments increased. Moreover, cT n T‐I‐C complex was more prominent in the early than in the late presenting patient. Conclusions This explorative study in non– ST ‐segment–elevation myocardial infarction shows that cTnT is released from cardiomyocytes as a combination of cT n T‐I‐C complex, free intact cTnT , and multiple cTnT fragments indicating intracellular cTnT degradation. Over time, the cT n T‐I‐C complex disappeared because of in vivo degradation. These insights might serve as a stepping stone toward a high‐sensitivity‐ cTnT immunoassay more specific for myocardial infarction.
- Published
- 2019