EXPERIENCE WITH CARDIAC TROPONIN-T IN DIFFICULT CASES

Recent years have seen the advent of new cardiac markers. These have b een shown to be valuable in large controlled clinical trials. The brea kthrough of the troponins worldwide for detection of myocardial lesion s has meant that the Cardiac Troponin T parameter has been available i n our hospital since August 1996. Analysis of the samples is carried o ut on the Elecsys, an automated immunology analyzer from Roche Diagnos tics, Austria. The purpose of the present paper is to investigate whet her study results on the diagnostic utility, sensitivity and specifici ty of troponin T can be confirmed in multimorbid patients in routine c linical practice, who are otherwise excluded from such trials. Troponi n T was investigated in five cases including patients presenting with myocarditis and parallel damage of the skeletal muscles, as well as in haemodialysis patients. Cardiac troponin T has proved to be a very re liable parameter in all of these patients due to its high sensitivity and specificity, where other conventional diagnostic procedures were n ot helpful due to co-morbidity and confounding factors. New clinically relevant information can be obtained by both individual as well as se rial measurements. Cardiac troponin T determination is a powerful new tool and should be considered seriously, regardless of other underlyin g diseases: it is, therefore, not only a diagnostic but also a managem ent tool.