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Updated: May 11, 2026

Isolation of Human Atrial Myocytes for Simultaneous Measurements of Ca2+ Transients and Membrane Currents
10:53

Isolation of Human Atrial Myocytes for Simultaneous Measurements of Ca2+ Transients and Membrane Currents

Published on: July 3, 2013

Atrial fibrillation-induced cardiac troponin I release

Abdul Shokor Parwani1, Leif-Hendrik Boldt, Martin Huemer

  • 1Department of Cardiology, Charité, Campus Virchow Clinic, Berlin, Germany.

International Journal of Cardiology
|April 30, 2013
PubMed

Insights

Elevated cardiac troponin I (cTnI) levels are common in patients with atrial fibrillation (AF) and may not indicate myocardial infarction. High heart rate and angina can cause false elevations, necessitating revised clinical guidelines.

Area of Science:

  • Cardiology
  • Biomarkers
  • Emergency Medicine

Background:

  • Cardiac troponin I (cTnI) is a key biomarker for diagnosing myocardial damage and acute coronary syndrome.
  • Atrial fibrillation (AF) is a common arrhythmia that can present with symptoms overlapping those of acute coronary syndrome.
  • The utility and predictive value of cTnI in AF patients presenting with acute symptoms remain to be fully elucidated.

Purpose of the Study:

  • To investigate the utility and predictive value of cardiac troponin I (cTnI) in patients diagnosed with atrial fibrillation (AF) presenting with symptoms suggestive of myocardial ischemia.
  • To determine the association between elevated cTnI levels and coronary artery disease in this patient population.

Main Methods:

  • A cohort of 354 consecutive patients with a primary diagnosis of AF and ischemic symptoms were studied.
  • Cardiac troponin I (cTnI) was measured on presentation; patients with ST-segment elevation myocardial infarction were excluded.
  • Coronary angiography was performed in 100 patients to assess for significant coronary stenosis.

Main Results:

  • Fifteen percent (51/354) of AF patients exhibited elevated cTnI levels (>0.09 μg/L).
  • Among patients undergoing coronary angiography, elevated cTnI had a low positive predictive value (26%) for significant stenosis, while normal cTnI had a 33% rate of significant stenosis.
  • Multivariate analysis identified heart rate, angina, left ventricular ejection fraction, serum creatinine, and hemoglobin as independent predictors of elevated cTnI.

Conclusions:

  • Atrial fibrillation in the acute setting is frequently associated with elevated cTnI levels, often unrelated to significant coronary artery disease.
  • Factors such as high heart rate and angina pectoris can lead to false-positive cTnI elevations in AF patients.
  • Clinical guidelines for interpreting cTnI in patients with acute AF and ischemic symptoms require revision to account for AF-related elevations.
Abstract

Keywords:
arrhythmiasatrial fibrillationbiomarkersemergency departmenttroponin

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