A current research has shown that troponin is a very good indicator of the future heart risk attacks and thus is more preferred than the other traditional methods which have shown negative results in the prediction of the heart diseases in the future. Risk of heart attack in the past is normally indicated by signs like the chest pain and other abnormalities which stem from the individuals heart. When the experts measure the chemicals in the blood to find out the damaged cells then they use the method of CK-MB and troponin methods and they are known methods which are very effective.
People who have contracted heart diseases and those who are at risk of contracting are said to be able to be told the lifespan of their lives by using the troponin tests. A research done showed that the use of CK-MB to predict the remaining lifespan of an individual may not be accurate than the use of the troponin tests. The test for troponin can even test the very small extends of damage which has occurred to the hears and infarclets. Patients who are found to have troponin are said to be well in their health but the rise in the levels of troponin will show an individuals high risks of having a chronic heart disease.
Latest developments of troponin There are so many developments which have occurred to the troponin protein which is a sure test of heart diseases. Inorder to study these developments we need to look at the researches which have been done by the current researchers. Coronary heart disease is one of the commonest in the family of cardiac diseases leading to myocardial infarction, sudden death, angina and other complications later on. These infections are known to be very dangerous and can transfer its causes and lead to sudden death within a short period of time.
During the initial stages ECG can be a good test for these complications but after a while they become chronic and tests like the use of CK-MB are very important. During this period troponin tests only give results after four hours of its use its sensitivity recorded as about 80-100% in its detection of myocardial infarction. A research done on some patients with myocardial infarction is one which can give us a good picture to how the troponin is considered the best test for the test of heart diseases.
These patients were subjected to ECG, CK-MB and troponin tests. Troponin test was taken as a bedside quantitative test and the procedure consists of putting a strip labeled that it contains the protein troponin. If it was found that the blood contained troponin it will react with the antibody in the strip and cause a mark inform of a coloured line on the strip. (Adams, 2001. Pp 250) Blood was collected using the sucking method where a pipette was involved, and it was made sure it was on the mark where it was to give quality results.
The appearance of the mark due to the reaction between the antibody and troponin was noted for every time the test was done. The variation in the times for every time the research was done was also noted down. The implication was that if two lines were found then the result was negative but the result is positive if only one line was noted. The observations made are that the sensitivity and the specificity of troponin tests were high in comparison to other tests like CK-MB ad SGOT. The result showed the following:
Troponin tests were discovered to be best when two hours elapsed after onset of the myocardial infection and remained in that condition for more than 12 hours. CK-MB and SCGOT were recorded to be 100% if the time of myocardial infarction had sustained more than 12hrs. Troponin test and the others are said to differ in their mode of time and their effectiveness. The research showed that when the three proteins are tested it showed their effectiveness. The following table shows the results: When the troponin test and the CK-MB tests are compared, there is more positivity in the troponin test.
IT was noted that the positivity in CK-MB was high only during the initial stages that is between the 2-4 hrs. We can conclude that troponin test is only strong after the first two hrs thus making it suoerior than other proteins. Positivity of troponin differs with the area in which there is occurrence of the infarction. The most noted cases which have been recorded and considered maximum positive are the anterior infarct at about 85% and the inferior myocardial infarction at about 59% The table below shows the positivity of the three proteins compared.
(Rosen, 1997 pp. 238-290) There has been an observation also about the mortality rates where the troponin test was noted to be positive within the first 5 minutes of the start of the myocardial infarction. CK-MB appears in the blood but is slightly not sensitive like the troponin test, his shows that troponin test is best for detecting the myocardial infarction earlier. There are other several notable developments of the troponin and some of them have been researched and the lately indexed ones include the:
• Etiologies of troponin elevation in the sick people with gastroigestinal bleeding • Phosphorylation of cardiac troponin which has been observed in the mammalian sterile. • The weight and nutrition effect and the spicing of a muscle gene associated with energy and performance including also life history • Serum cardiac troponin as a prognostic marker in septic shock. • Gender dependant impact of risk factors for non cardiovascular and cardiovascular mortality in end stage renal diseases patients under the process of haemodialysis.
• Requirement of the site for the direct repeats and Overlapping GATA for maintaining the specific expression of cardiac troponin developing mice. • Cardiac troponin in pre end stage kidney disease • Suppression of cardiac troponin which has been known to reduce contractility and structural disorganization in the chicken species. • Neuregulin promotes cardiomyocite differentiation of the engineered embryonic stem cell clones. • The perfect biomarker in the acute coronary syndrome which has brought a challenge in the prognosis, diagnosis and treatment.
These among others are the developments which have been noted for troponins. There effectiveness and efficiency continue to be felt allover and most hospitals are adopting its use because they are considered perfect. (August, 1999. pp 680) There are however limitations about this procedure of test i. e. the troponin test and some of the limitations are: • If the study is conducted qualitatively, then it will not give a very nice picture about the entire test. • Quantitative tests and estimations are better when they are used in the detection of micro infarcts.
• Qualitative estimation shows the troponin levels above a certain level above a certain level only. • The findings of the qualitative method may account for the difference in the sensitivity for anterior and inferior infarctions. • The test should be used with other clinical signs and symptoms and other test results to diagnose AMI. • As with all diagnostic tests, a definite clinical diagnosis should not be taken only as a result of performing a few tests but should undergo thorough clinical and laboratory findings by a physician.
Our hospitals currently are starting to use troponin levels along with CK-MB levels to test for CI n their bodies. Troponin however is considered the best method of testing MI and the phycists say will go along way into the future. There is a new and more troponin research which has been done and this gives the test the best reasons why these physists think troponin test hold the promise of improving the diagnosis of MI in the future. A research has indicated that there is need for quantitative tests to improve the way of perception of troponin.
It should all start with perception and then the next level is to know whether there really is a level which we can say determines the amount of MI in the body, do we really have to see the rise in the level so that we say the patient is suffering from MI? (August, 1999. pp 680) After realizing this we need to identify more cases of acute MI and be able to subject troponin to it and see the reaction. Is troponin able to curb the changing strides of MI?
The research shows that acute MI changes with the settings so that what happens to be occurring in the present is more sensitive than what happened in the past. The other phenomena we need to find out is the ability to curb what will increase in the future. There is a prediction that there will be a rise in the numbers of the people with chronic acute diseases and therefore there is a need to find out the elevations of the troponin protein and its effect on the increase of elevations.
Questions which are of dire concern are whether the troponin level will go up, go down or being elevated and staying constant. Will there be physical injury which will make the level go up or will there be a constant figure and if there is a permanent failure of the heart which a risk expected to occur are we in a position then of seeing the level being elevated? Conclusion There are several ways of evaluating the heart damage by measuring the components of the blood and researches have found out that these are very efficient methods and must be embraced in the current medical systems of the modern world.
Some of the fundamental and well researched methods is the use of troponin which has been found out that is one of the most efficient way for testing myocardial infarction. There are however more developments taking place in this and the researches belief that after the whole procedure has been understood very well it will go along way in the treatment of patients with the heart diseases. Everyday more research is being done and this will see a new wave in the use of troponin.