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Determination of Cardiac Troponin I Forms in the Blood of Patients with Acute Myocardial Infarction and Patients Receiving Crystalloid or Cold Blood Cardioplegia

¹ Sanofi Diagnostics Pasteur, Z.A. Leopha Rue d'Italie, 69780 Mions, France.

² Centre Hospitalio Universitaire Nîmes, Service de Cardiologie, 30006 Nîmes, France.

³ Centre National de la Recherche Scientifique, Unité Mixte de Recherche, 9921, Faculté de Pharmacie, 34060 Montpellier, France.

⁴ Sanofi Recherche, 34084 Montpellier, France.

⁵ Hôpital St. Jacques, 25030 Besançon, France.

⁶ Sanofi Diagnostics Pasteur, 92230 Marnes-la-Coquette, France.
^a Author for correspondence. Fax 33 4 78 21 75 06; e-mail sylvie.trinquier{at}sanofi.com.

To determine the forms of cardiac troponin I (cTnI) circulating in the bloodstream of patients with acute myocardial infarction (AMI) and patients receiving a cardioplegia during heart surgery, we developed three immunoenzymatic sandwich assays. The first assay involves the combination of two monoclonal antibodies (mAbs) specific for human cTnI. The second assay involves the combination of a mAb specific for troponin C (TnC) and an anti-cTnI mAb. The third assay was a combination of a mAb specific for human cardiac troponin T (cTnT) and an anti-cTnI mAb. Fifteen serum samples from patients with AMI, 10 serum samples from patients receiving crystalloid cardioplegia during heart surgery, and 10 serum samples from patients receiving cold blood cardioplegia during heart surgery were assayed by the three two-site immunoassays. We confirmed that cTnI circulates not only in free form but also complexed with the other troponin components (TnC and cTnT). We showed that the predominant form in blood is the cTnI-TnC binary complex (IC). Free cTnI, the cTnI-cTnT binary complex, and the cTnT-cTnI-TnC ternary complex were seldom present, and when present, were in small quantities compared with the binary complex IC. Similar results were obtained in both patient populations studied. These observations are essential for the development of new immunoassays with improved clinical sensitivity and for the selection of an appropriate cTnI primary calibrator.

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