Progress, Opportunities, and Challenges of Troponin Analysis in the Early Diagnosis of Cardiovascular Diseases Anal. Chem. 2022, 94, 1, 442–463

Progress, Opportunities, and Challenges of Troponin Analysis in the Early Diagnosis of Cardiovascular Diseases

Anal. Chem. 2022, 94, 1, 442–463

Biomarkers are considered to be indicative of pathogenic processes resulting from different diseases, which are typically present in biological fluids including blood, urine, and cerebrospinal fluid and exhaled. Despite the availability of such biomarkers providing important information about the status of a disease, their extremely low concentrations in biological samples make it extremely challenging to provide a clear guideline in the diagnosis and treatment of diseases. Like many other diseases, biomarkers used for AMI should also be specific, meaning that they should be present in high concentrations in the myocardium, rather than in the noncardiac tissues. The earliest cardiac biomarkers include lactate dehydrogenase, lactate dehydrogenase isoenzymes, creatine kinase, aspartate transaminase, and creatine kinase; however, these biomarkers have poor specificity for the detection of cardiac injury because of their wide tissue distribution. Recently, several biomarkers appeared for AMI analysis, including myoglobin (MB), creatine kinase-myoglobin (CK-MB), cardiac troponin proteins (cTn), noncoding RNA, natriuretic peptides, C-reactive protein, myeloperoxidase, TNF-alpha, and heart fatty acid binding protein, with the former three (CK-MB, MB, and cTn proteins) recognized in clinical settings and the others limited in fundamental research. Among these, cTn proteins have been considered a gold standard for clinical diagnosis of AMI.