Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Mar 26, 2016; 8(3): 293-301
Published online Mar 26, 2016. doi: 10.4330/wjc.v8.i3.293
Typical rise and fall of troponin in (peri-procedural) myocardial infarction: A systematic review
Dianne van Beek, Bas van Zaane, Marjolein Looije, Linda Peelen, Wilton van Klei
Dianne van Beek, Bas van Zaane, Linda Peelen, Wilton van Klei, Department of Anesthesiology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
Marjolein Looije, Department of Cardiothoracic Surgery, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
Author contributions: van Beek D wrote the paper; van Beek D and Looije M performed the research; van Beek D and Peelen L analyzed the data; van Zaane B designed the research; van Zaane B, Peelen L and van Klei W supervised the paper; all authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author at diannevanbeek@hotmail.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dianne van Beek, MsC, Department of Anesthesiology, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. diannevanbeek@hotmail.com
Telephone: +31-88-7559619 Fax: +31-32-541828
Received: September 30, 2015
Peer-review started: October 8, 2015
First decision: November 4, 2015
Revised: November 26, 2015
Accepted: January 5, 2016
Article in press: January 7, 2016
Published online: March 26, 2016
Processing time: 173 Days and 15.8 Hours
Abstract

AIM: To identify the typical shape of the rise and fall curve of troponin (Tn) following the different types of myocardial infarction (MI).

METHODS: We conducted a systematic search in PubMed and Embase including all studies which focused on the kinetics of Tn in MI type 1, type 4 and type 5. Tn levels were standardized using the 99th percentile, a pooled mean with 95%CI was calculated from the weighted means for each time point until 72 h.

RESULTS: A total of 34 of the 2528 studies identified in the systematic search were included. The maximum peak level of the Tn was seen after 6 h after successful reperfusion of an acute MI, after 12 h for type 1 MI and after 72 h for type 5 MI. In type 1 MI there were additional smaller peaks at 1 h and at 24 h. After successful reperfusion of an acute MI there was a second peak at 24 h. There was not enough data available to analyze the Tn release after MI associated with percutaneous coronary intervention (type 4).

CONCLUSION: The typical rise and fall of Tn is different for type 1 MI, successful reperfusion of an acute MI and type 5 MI, with different timing of the peak levels and different slopes of the fall phase.

Keywords: Troponin; Myocardial infarction; Systematic review; Reperfusion; Coronary artery bypass grafting

Core tip: In this systematic review we aimed to identify the typical rise and fall of cardiac troponin (Tn) in the different types of myocardial infarction (MI). A total of 34 of the 2528 studies identified in the systematic search were included. The typical rise and fall of Tn is different for type 1 MI, successful reperfusion of an acute MI and type 5 MI, with different timing of the peak levels and different slopes of the fall phase.