What Causes Elevated Troponin Levels?

Myocardial necrosis, or irreversible damage to tissues of the heart, and unstable angina both cause elevated levels of troponin. In both cases, the short-term and long-term prognoses are negative for the patient, according to Mayo Clinic.

Troponin T is a protein that appears in striated muscle, and it combines with troponin I and troponin C, two other proteins, to create troponin. Troponin appears both free and bound to proteins. Troponin tests detect the release of troponin T, which happens as the heart begins to experience myocardial damage. The heart releases free troponin T at the onset of heart damage and later releases the troponin T, which is connected to the other two proteins as the damage continues, as stated by Mayo Clinic.

Once the previously bound troponin T is released, that is a sign that myofibrils within the heart have started to break down, most commonly as a result of myocardial ischemia or an acute myocardial infarction. Once the myocardial tissue starts to die, the troponin levels increase within a few hours and can stay high for as long as two weeks, according to Mayo Clinic.

Patients who have unstable angina initially experience elevated troponin T levels as a result of the angina itself. Later, elevated troponin T levels are the result of treatment with antiplatelet drugs as well as low-molecular-weight heparin, as stated by Mayo Clinic.