Related Experiment Video
Updated: Aug 23, 2026
A Sensitive and Specific Quantitation Method for Determination of Serum Cardiac Myosin Binding Protein-C by Electrochemiluminescence Immunoassay
Published on: August 8, 2013
Elevated serum cardiac troponin I in rhabdomyolysis
Gopikrishna Punukollu1, Ramesh M Gowda, Ijaz A Khan
1Division of Cardiology, Long Island College Hospital, Brooklyn, NY, USA.
Insights
Elevated cardiac troponin I (cTnI) in rhabdomyolysis is often unrelated to muscle damage and may indicate illicit substance use, hypotension, or sepsis. This elevation is linked to increased morbidity but not mortality.
Area of Science:
- Cardiology
- Nephrology
- Toxicology
Background:
- Rhabdomyolysis, a condition characterized by muscle breakdown, can lead to elevated cardiac troponin I (cTnI) levels.
- The precise etiology and clinical significance of elevated cTnI in rhabdomyolysis patients remain incompletely understood.
Purpose of the Study:
- To investigate the causes and clinical implications of elevated serum cTnI in patients diagnosed with rhabdomyolysis.
- To determine if elevated cTnI correlates with the extent of muscle damage, renal impairment, or cardiovascular risk factors.
Main Methods:
- A retrospective analysis of 91 patients with rhabdomyolysis was conducted.
- Patients were categorized into cTnI-positive (>0.6 ng/ml) and cTnI-negative (<0.6 ng/ml) groups.
- Clinical data, including risk factors, substance use, laboratory values (creatine kinase, creatinine), and outcomes, were compared between groups.
Main Results:
- Elevated cTnI was associated with higher rates of illicit substance use, hypotension, and sepsis.
- Patients with elevated cTnI showed higher peak creatine kinase levels and serum creatinine, but no direct correlation with cTnI levels.
- Despite longer hospitalization, elevated cTnI did not correlate with increased mortality.
Conclusions:
- Elevated serum cTnI in rhabdomyolysis is often not directly related to muscle damage or renal failure.
- The elevation appears linked to the underlying cause of rhabdomyolysis, such as substance use, hypotension, or sepsis.
- Elevated cTnI in this context signifies increased patient morbidity.
Objective:
To examine the etiology and clinical significance of elevated serum cardiac troponin I (cTnI) in patients with rhabdomyolysis.
Methods:
Data on 91 (63 men) consecutive patients with rhabdomyolysis were examined.
Results:
The mean age was 57.8+/-19.6 years (range 24-97 years). Patients were divided into two groups: cTnI-positive with serum cTnI >0.6 ng/ml (n=19) and cTnI-negative with serum cTnI <0.6 ng/ml (n=72). Prevalence of cardiovascular risk factors was equal in both groups. Illicit substance use was more common in the cTnI-positive group (31% vs. 14%, P=0.04). Peak creatine kinase (CK) was higher in cTnI-positive group (34,811+/-38,309 vs. 15,070+/-21,655 U/l, P=0.04) but there was no difference in the MB isoenzyme (CK-MB) (118+/-132 vs. 89+/-451 ng/ml, P=0.63). In cTnI-positive group, there was a strong correlation between peak CK and CK-MB (r(2)=0.606, P=0.00008) but not between peak cTnI and peak CK (r(2)=0.164 and P=0.08) or CK-MB (r(2)=0.134 and P=0.12) levels. Serum creatinine was higher in cTnI-positive group (3.58+/-2.73 vs. 1.83+/-2.01 mg/dl, P=0.02) but there was no correlation between serum creatinine and cTnI (r(2)=0.121, P=0.158). None of the cTnI-positive patient had segmental wall motion abnormalities. Seventeen (89%) patients in cTnI-positive and 19 (26%) in cTnI-negative group required admission to intensive care unit (P=0.0001). Hypotension (37% vs. 6%, P=0.0002) and sepsis (47% vs. 11%, P=0.0003) were more common in cTnI-positive group. Duration of hospitalization was longer in cTnI-positive group (17.7+/-11.7 vs. 8.9+/-13 days, P=0.007) but there was no significant difference in mortality.
Conclusion:
In rhabdomyolysis, serum cTnI may be elevated unrelated to the degree of muscle damage, renal failure and cardiovascular risk factors, and is likely related to the etiology of rhabdomyolysis, as is evidenced by significantly higher serum cTnI with illicit substance use, hypotension, and sepsis. Elevated serum cTnI is associated with a higher morbidity.
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:24Serum Studies: Renal Function Tests
01:30Acute Coronary Syndrome I: Introduction
01:22Acute Kidney Injury I: Introduction
01:27Myocarditis II: Clinical Features and Diagnostic Tests
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...