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Related Experiment Video

Updated: Jun 9, 2026

Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease

Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease

Published on: July 3, 2018

Outcomes associated with small changes in normal-range cardiac markers.

Nolan McMullin¹, Christopher J Lindsell, Lei Lei

¹The Cleveland Clinic, Cleveland, OH, USA.

The American Journal of Emergency Medicine

|September 10, 2010

Summary

Even small increases in troponin levels below the normal limit may indicate a higher risk of acute coronary syndrome (ACS). Monitoring these subtle troponin fluctuations can aid in early detection of heart conditions.

Related Experiment Videos

Last Updated: Jun 9, 2026

Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease

Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease

Published on: July 3, 2018

Area of Science:

Cardiology
Biomarkers
Emergency Medicine

Background:

Troponin concentrations above institutional cutpoints define acute myocardial necrosis.
The clinical significance of troponin fluctuations below these cutpoints remains unclear.
This study investigates the association between sub-threshold troponin changes and acute coronary syndrome (ACS).

Purpose of the Study:

To evaluate the association between troponin fluctuations below the upper limit of normal and the occurrence of acute coronary syndrome (ACS).

Main Methods:

Post hoc analysis of the Internet tracking registry of ACS (i*trACS) dataset.
Included patients (≥18 years) with suspected ACS and at least two cardiac marker measurements (troponin T, troponin I, or CK-MB) within 6 hours, both below the institutional upper limit of normal.
Defined marker change as >15% fluctuation; ACS defined as positive stress test, myocardial infarction, revascularization, or 30-day death.

Main Results:

2162 of 17,713 patient visits met inclusion criteria.
Increasing troponin levels below the upper limit of normal were associated with significantly increased odds of ACS (OR, 3.6; 95% CI, 1.4-9.2).
Neither changing creatine kinase-MB (CK-MB) nor decreasing troponin levels showed an association with increased ACS odds.

Conclusions:

Subtle increases in troponin concentration below the established upper limit of normal are linked to a higher likelihood of acute coronary syndrome (ACS).
These findings suggest that monitoring minor troponin changes may improve early diagnosis of ACS.