Extract

During the past few years, the cardiac-specific isoforms of troponin T (cTnT) and troponin I have been introduced as specific markers of myocardial injury (1)(2)(3). Measurements of the cardiac-specific troponins are superior to the creatine kinase MB isoenzyme (CK-MB) for the detection of myocardial injury; they also eliminate the need to measure lactate dehydrogenase-1, a late marker of cardiac injury (4)(5)(6). A special feature of the cardiac troponins is the ability to detect minor myocardial injury in patients with unstable angina pectoris (UAP) and to add prognostic information regarding future adverse coronary events in this group of patients (7)(8).

The assays for the determination of cTnT include the ES-system (Boehringer Mannheim), which has been on the market for several years (9), and the new random-access electrochemoluminescence system (Elecsys, Boehringer Mannheim) (10). The second generation of ELISA for the ES system, Enzymun Troponin T, includes a new monoclonal anti-cTnT antibody, thus eliminating the slight cross-reactivity with skeletal muscle TnT that was associated with the first-generation ELISA (ELISA Troponin T). The second-generation ELISA system is, therefore, claimed to be absolutely specific for the cardiac isoform (11).

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