Development of a long troponin T fragment assay for myocardial infarction diagnosis
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Myocardial infarction (MI) is one of the leading causes for loss of life in developed
countries. MI occurs when oxygenated blood flow to the cardiac muscle declines or is
totally terminated. Diagnosis of MI relies on symptoms, electrocardiogram, and
biomarkers such as cardiac troponins. However, there are numerous medical
conditions beside MI that may increase the troponin level in the blood such as chronic
kidney disease (CKD). Also, CKD causes challenges with electrocardiogram leaving
diagnosis relying heavily on troponin. Ongoing MI releases continuously intact long
troponin into bloodstream which is cleaved and cleared away from the bloodstream.
The aim of this study was to research, develop and test an immunoassay test for long
troponin T fragment.
The first stages of the assay development focused on solving the issue of matrix
interference and analytical sensitivity by optimizing buffer compositions, antibodies,
and assay parameters. The final optimized assay was tested with samples from MI
patients and with samples taken from patients with troponin elevating conditions like
CKD.
The developed assay is capable to differentiate MI from other troponin elevating
conditions. The assays area under the curve was 0.867. More testing with this assay is
needed confirm its capabilities. This assay might serve as alternative assay for MI for
patients who suffer from cardiac troponin elevating diseases such as CKD.