Causes of Elevated Troponin Levels
Type | Conditions |
|---|---|
Myocardial ischemia | |
ACS | Classic AMI |
Non-ACS (coronary) | Increased demand (stable coronary artery disease lesion) Coronary artery spasm, embolism, or dissection Procedure-related (PCI, CABG) Cocaine or methamphetamine |
Non-ACS (noncoronary) | Hypoxia Global ischemia Hypoperfusion Cardiothoracic surgery |
Sudden cardiac death | — |
Direct myocardial damage (nonischemic) | |
Cardiac disorders | Cardiomyopathy (eg, hypertrophic, viral) Injury (ablation procedures, cardiac contusion, cardioversion, electrical shock) Cancer Infiltrative disorders (eg, amyloidosis) |
Systemic disorders | Toxicity (eg, anthracyclines) Trauma (eg, severe burns) Extreme exertion Subarachnoid hemorrhage |
Analytical | |
Assay-based | Poor performance Calibration errors |
Sample-based | Heterophile antibody Interference by substances |
ACS = acute coronary syndrome; AMI = acute MI; CABG = coronary artery bypass grafting; MI = myocardial infarction; NSTEMI = non–ST-segment elevation MI; PCI = percutaneous coronary intervention; STEMI = ST-segment elevation MI. | |