Development of a long troponin T fragment assay for myocardial infarction diagnosis

Abstract

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.