ABSTRACT
Cardiac troponins T and I are considered highly sensitive and specific markers for the diagnosis of acute myocardial infarction. Currently, a series of nonprimary cardiac abnormalities may manifest as an elevation in high-sensitive assays. The reduction in their detection limits has allowed earlier diagnosis and the use of evidence-based therapeutic measures; however, this characteristic has increased the spectrum of detectable noncoronary heart diseases, which poses challenges for characterizing acute coronary syndromes and creates a new role for these tests in known disorders in intensive care units, especially sepsis. Management of patients through a greater understanding of how these markers behave should be re-evaluated to ensure their correct interpretation.
Keywords:
Troponin T; Troponin I; Myocardial infarction; Biomarkers; Sepsis; Intensive care units
Source: Adapted from Garg P, Morris P, Fazlanie AL, Vijayan S, Dancso B, Dastidar AG, et al. Cardiac biomarkers of acute coronary syndrome: from history to high-sensitivity cardiac troponin. Intern Emerg Med. 2017;12(2):147-55. 
Source: Adapted from Hickman PE, Potter JM, Aroney C, Koerbin G, Southcott E, Wu AH, et al. Cardiac troponin may be released by ischemia alone, without necrosis. Clin Chim Acta. 2010;411(5-6):318-23. 
Source: Adapted from Sandoval Y, Thygesen K. Myocardial infarction type 2 and myocardial injury. Clin Chem. 2017;63(1):101-7.(