Tissue specificity of cardiac troponin I, cardiac troponin T and creatine kinase-MB.

The purpose of the paper is to review the tissue specificity of creatine kinase (CK)-MB, cardiac troponin I (cTnI), and cardiac troponin T (cTnT) in human and animal heart and skeletal muscle. Alterations are described which demonstrate that CK-MB is expressed in human skeletal muscle, and is not 100% specific for the heart. cTnI has been shown to be 100% specific for the heart. While cTnT isoforms are expressed in injured skeletal muscle, they are not detected by the diagnostic assays used in clinical practice. Therefore, cTnI or cTnT challenge CK-MB as the new standards for detection of myocardial injury.     

Utility of Troponin I in Patients with Cocaine-associated Chest Pain

Baseline electrocardiogram abnormalities and market elevations not associated with myocardial necrosis make accurate diagnosis of myocardial infarction (MI) difficult in patients with cocaine-associated chest pain. Troponin sampling may offer greater diagnostic utility in these patients. OBJECTIVE: To assess outcomes based on troponin positivity in patients with cocaine chest pain admitted for exclusion of MI. METHODS: Outcomes were examined in patients admitted for possible MI after cocaine use. All patients underwent a rapid rule-in protocol that included serial sampling of creatine kinase (CK), CK-MB, and cardiac troponin I (cTnI) over eight hours. Outcomes included CK-MB MI (CK-MB >or= 8 ng/mL with a relative index [(CK-MB x 100)/total CK] >or= 4, cardiac death, and significant coronary disease (>or=50%). RESULTS: Of the 246 admitted patients, 34 (14%) met CK-MB criteria for MI and 38 (16%) had cTnI elevations. Angiography was performed in 29 of 38 patients who were cTnI-positive, with significant disease present in 25 (86%). Three of the four patients without significant disease who had cTnI elevations met CK-MB criteria for MI, and the other had a peak CK-MB level of 13 ng/mL. Sensitivities, specificities, and positive and negative likelihood ratios for predicting cardiac death or significant disease were high for both CK-MB MI and cTnI and were not significantly different. CONCLUSIONS: Most patients with cTnI elevations meet CK-MB criteria for MI, as well as have a high incidence of underlying significant disease. Troponin appears to have an equivalent diagnostic accuracy compared with CK-MB for diagnosing necrosis in patients with cocaine-associated chest pain and suspected MI.     

心肌标志物作用的系统分析

目的：获取心肌生化标记物的最佳应用证据。方法：查循、浏览对心肌肌酸激酶同工酶MB（CK－MB）、肌红蛋白、心肌肌钙蛋白T（cTnT）和心肌肌钙蛋白I（cTnI）用于诊断心肌梗塞（MI）和对急性冠状动脉综合症分级的系统评价和Meta－分析的文献资料。结果：在症状发生后的12－48小时采样分析CK－MB质量对于诊断MI的临床灵敏度和牧场划性分别是98．8％和89．6％。肌红蛋白有高的阴性预示值,在症状发生后的2－6小时采样分析有高的临床灵敏度。在症状发生后的12采样cTnI,诊断MI的临床灵敏度和特异性分别是98．2％和68．8％,其临床特异性降低与检测到微小心肌受损有关。结论：cTnT和cTnI比CK－MB对诊断心肌梗死和预测急性冠状动脉综合症危险性更有价值。     

心肌肌钙蛋白I和T联合检测在病毒性心肌炎诊断中的应用

目的探讨肌钙蛋I（cTnI）和肌钙蛋白T（cTnT）在病毒性心肌炎（VMC）的诊断及病情观察方面的价值。方法对79例VMC患者进行入院后1、2、3周及2个月cTnT和心肌酶谱的动态监测；cTnT、cTnI与心电图（ECG）及病程关系的研究。结果急性VMC患者在各检测期内血清cTnT的阳性率（73．41％）和cTnI的阳性率（67．08％）显著高于心肌酶谱各项目（P〈0．05）：肌酸激酶47．4d％、肌酸激酶同工酶51．28％、天冬氨酸氨基转移酶42．31％、乳酸脱氢酶42．31％、α-羟丁酸脱氢酶44．87％。cTnT和cTnI阳性组ECG正常率（5．26％、9．62％）明显低于阴性组（71．43％、57．69％）（P〈0．05）。结论在VMC的诊断中，cTnT和cTnI可取代传统的心肌酶谱测定作为判断急性心肌炎的指标；同时cTnT和cTnI在VMC病情进展的观察中也具有重要意义。     

Cardiac troponins and creatine kinase content of striated muscle in common laboratory animals

Animal models are important for the investigation of human heart pathology, novel treatments, and medical or surgical interventions for disease. Serum markers of myocardial damage may also be important tools within this field of research. In order to assess the cardiac specificity of widely utilised serum markers, we measured the cardiac troponins and creatine kinase (CK) isoenzymes in cardiac and skeletal muscle samples taken from dog, monkey, pig and rat. These samples were also analysed by immunoblotting for cardiac troponin I (cTnI) and cardiac troponin T (cTnT). The content of cTnI and cTnT in skeletal muscle was below 0.6% of that found in heart for all animal species studied. This low immunoreactivity in skeletal muscle was confirmed by immunoblot analysis. The content of CK was higher in skeletal muscle than in heart muscle for all species. The CK-MB/total CK ratio was lower in skeletal muscle than in cardiac muscle for all species. The differences in CK-MB content of skeletal muscle and heart muscle were much less pronounced than the tissue differences in the amounts of the cardiac troponins. The cardiac troponins are potentially useful serum markers of myocardial damage, with high specificity for myocardial muscle in these common laboratory animals. Creatine kinase-MB is much less cardiac-specific.     

Clinical and experimental results on cardiac troponin expression in Duchenne muscular dystrophy

BACKGROUND: Because of controversial earlier studies, the purpose of this study was to provide novel experimental and additional clinical data regarding the possible reexpression of cardiac troponin T (cTnT) in regenerating skeletal muscle in Duchenne muscular dystrophy (DMD). METHODS: Plasma from 14 patients (mean age, 7.5 years; range, 5.7-19.4 years) with DMD was investigated for creatine kinase (CK), the CK MB isoenzyme (CKMB), cTnT and cardiac troponin I (cTnI), and myoglobin. cTnT concentrations were measured by an ELISA (second-generation assay; Roche) using the ES 300 Analyzer. cTnI, myoglobin, and CKMB were measured by an ELISA using the ACCESS System (Beckman Diagnostics). Troponin isoform expression was studied by Western blot analysis in remnants of skeletal muscle biopsies of three patients with DMD and in an animal model of DMD (mdx mice; n = 6). RESULTS: There was no relation of cTnT and cTnI to clinical evidence for cardiac failure. cTnI concentrations remained below the upper reference limit in all patients. cTnT was increased (median, 0.11 microg/L; range, 0.06-0.16 microg/L) in 50% of patients. The only significant correlation was found for CK (median, 3938 U/L; range, 2763-5030 U/L) with age (median, 7.5 years; range, 6.8-10.9 years; r = -0.762; P = 0.042). Western blot analysis of human or mouse homogenized muscle specimens showed no evidence for cardiac TnT and cTnI expression, despite strong signals for skeletal muscle troponin isoforms. CONCLUSIONS: We found no evidence for cTnT reexpression in human early-stage DMD and in mdx mouse skeletal muscle biopsies. Discrepancies of cTnT and cTnI in plasma samples of DMD patients were found, but neither cTnT nor cTnI plasma concentrations were related with other clinical evidence for cardiac involvement.     

血清心肌肌钙蛋白对心肌损伤的临床诊断价值

目的　探讨定量分析肌钙蛋白T(cTnT)、肌钙蛋白I(cTnI)对心肌损伤程度评价的临床意义。方法　对80例心肌梗死患[急性心肌梗死(AMI)50例、陈旧性心肌梗死(OMI)30例]、100例心脏手术患、60例非心脏手术患和20例健康人进行了血清cTnT、cTnI、肌酸激酶同工酶(CK—MB)和肌酸激酶(CK)检测。结果　(1)血清cTnT、cTnI、CK—MB和CK检测心肌损伤的敏感度和特异性分别为cTnT(72.4％，100.0％)、cTnI(81.8％，100.0％)，CK—MB(54.6％，87.5％)和CK(64.8％，62.2％)。(2)AMI和心脏手术组cTnT、cTnI、CK—MB和CK四项指标浓度均显高于正常对照组(P＜0.01)。(3)急性心肌梗死组、心脏手术组3h内cTnT和cTnI阳性检出率分别为(50％，56％)和(44％，45％)，明显高于CK—MB(24％，22％)和CK(20％，28％)；急性心肌梗死组、心脏手术组5d后cTnT和cTnI阳性检出率为(70％，66％)和(66％，61％)，而CK—MB仅为(4％，6％)，CK仅为(8％，10％)。结论　血清cTnT、cTnI能确切反映急性心肌梗死、心脏手术等心肌损伤程度，具有较宽的诊断窗口时间，是心肌损伤较敏感和特异的血清标志物。     

Myoglobin,creatine kinase MB isoforms and creatine kinase MB mass in early diagnosis of myocardial infarction in patients with acute chest pain

OBJECTIVES: Measurements of myoglobin and creatine kinase (CK)-MB isoforms have been suggested to be sensitive tests for the early diagnosis of myocardial infarction (MI). We have investigated the utility of myoglobin, creatine kinase (CK)-MB isoforms and creatine kinase MB mass (CK-MBm) in early diagnosis of MI using cardiac troponin T (cTnT) positivity as a reference. DESIGN AND METHODS: The study population comprised 440 patients who had had chest pain for less than 12 h. Patients were divided into cTnT negative (cTnT-) or cTnT positive (cTnT+) patients (concentration of cTnT >0.1 microg/L at two different time points during 72 h). RESULTS: At the time of admission to the emergency department receiver operating characteristics (ROC) curves of CK-MB isoforms and CK-MBm were not better than that of myoglobin. Six hours after admission CK-MB isoforms and CK-MBm provided statistically significantly larger areas under the curve (AUC) than myoglobin (p < 0.01). When ROC curves were related to the onset of chest pain (< 3 h, 3-6 h, and > 6 h) there were no significant differences between the cardiac markers studied. CONCLUSIONS: According to the present findings, CK-MB isoforms or myoglobin offer no advantage over CK-MBm as early markers of myocardial infarction.     

心肌肌钙蛋白I、肌钙蛋白T、肌酸激酶同工酶MB早期诊断 急性心肌梗死敏感性及特异性比较分析

目的 探讨心肌肌钙蛋白Ⅰ（cTnI)、 肌钙蛋白T（cTnT)、 肌酸激酶同工酶MB（CK－MB）早期诊断急性心肌梗死的临床应用价值。方法 对60例急性心肌梗死（AMI）和40例不稳定型心绞痛（UA）患者的同一血样标本检测cTnI、cTnT、CK－MB3项指标,分别进行两组间比较,并对 AMI组和UA组各指标作对比分析。结果 cTnI、cTnT早期诊断急性心肌梗死灵敏度高于CK－MB,阳性率分别为63.3%、46.7%、18.3％,P＜0.01;cTnI和cTnT无显著差别,P＞0.05;cTnI、cTnT、CK－MB特异性相当。结论 心肌肌钙蛋白I和肌钙蛋白T对于AMI的早期诊断具有较高灵敏度和较强特异性,是心肌损伤特异笥标志物,cTnI检测方便、快捷、准确,具有较好的临床价值。     

Role of cardiac troponin I in the evaluation of myocardial injury

Cardiac troponin I (cTnI) is highly specific for cardiac muscle. In this study, we compared the utility of CK and CK-MB index versus cTnI in the assessment of myocardial infarction in 155 patients being evaluated for myocardial damage. As a cardiac marker for MI, Troponin I seems to be superior to CK-MB. In the subset of patients with renal disease, cTnI has definite advantages over CK-MB. In addition, the use of cTnI has the potential to replace the measurement of lactate dehydrogenase isoenzymes. J. Clin. Lab. Anal. 12:276–279, 1998. © 1998 Wiley-Liss, Inc.     

Comparative study of cardiac troponin I and T measurements in a routine extra-cardiological clinical setting.

This study compared troponin I (cTnI) to troponin T (cTnT) in a population admitted to General Medicine Divisions in whom acute myocardial infarction (AMI) was suspected; 98 consecutive patients were included. Diagnoses were made without knowledge of troponin results: 51 patients had AMI, and 47 (including 8 with unstable angina) had no AMI. Patients were considered to be troponin positive if the marker concentration was >99th percentile value of the reference population. Both troponins were associated with an almost absolute sensitivity for AMI (100% for cTnI and 98.0% for cTnT), while the specificity was marginally higher for cTnI (78.7% vs. 68.1%). Increased cTnI and/or cTnT were observed in 15 patients out of 39 without acute coronary syndromes. Simultaneous positivity was seen in 8 patients with severe disorders and complications. Discordances were more frequent in favor of increased cTnT (n = 5) than the opposite (n = 2), even if this difference did not achieve statistical significance. cTnI and cTnT detected AMI with comparable efficiency. Cases without coronary syndrome positively concordant for troponins confirmed the ability of these biomarkers to detect myocardial injury undetectable by conventional diagnostic approaches.     

Serum cardiac troponin T in patients hospitalized with heart failure is associated with left ventricular hypertrophy and systolic dysfunction

BACKGROUND: Cardiac troponin T (cTnT) is a highly sensitive and specific marker of acute myocardial infarction. Serum cTnT is also slightly elevated in patients with severe heart failure and is associated with left ventricular hypertrophy (LVH) in patients treated with haemodialysis. In this study serum cTnT concentrations and echocardiographic findings were investigated in heart failure patients without acute coronary syndrome. cTnT was also compared with other cardiac markers and plasma levels of brain natriuretic peptide (BNP). METHODS: Twenty-six patients hospitalized with heart failure were included in the study. Echocardiographic measurements and blood sampling were carried out 12-36 h after admission. Serum cTnT (3rd generation assay), cardiac troponin I (cTnI), creatine kinase MB (CKMB) and CK were measured. Plasma BNP was analysed using the Shionoria assay. LVH was defined as left ventricular mass index (LVMI) > 125 g/m for males and > 110 g/m for females. Left ventricular systolic function was estimated from the mitral annulus motion (AV-mean LV). RESULTS: Median cTnT was 0.012 (< 0.010-0.032) microg/L. Sixty-two percent of the patients (16 of 26) had elevated serum cTnT >or= 0.010 micro/L. cTnT was positively correlated with CKMB (rho = 0.40, p = 0.04) and BNP (rho = 0.43, p = 0.03), but not with cTnI and CK. A negative correlation was found between cTnT and AV-mean LV (rho = -0.58, p = 0.007), and there was a positive correlation between cTnT and LVMI (rho = 0.44, p = 0.03). No other analyte was correlated to LVMI. CONCLUSIONS: Serum cTnT but not cTnI was associated with left ventricular dysfunction and LVH in patients hospitalized with heart failure. This explains why cTnT tends to be slightly elevated in patients with heart failure without symptoms of acute myocardial ischaemia.     

Cardiac troponin T and I in end-stage renal failure

BACKGROUND: In patients suffering from end-stage renal failure, cardiac troponin T (cTnT) and I (cTnI) may be increased in serum without other signs of acute myocardial damage. Whether these increases are specific to myocardial injury or nonspecific is not completely clear. METHODS: We investigated time courses of cTnT and cTnI over 1 year and the clinical outcome over 2 years in 59 patients with end-stage renal failure undergoing chronic hemodialysis. At the start of the study, we divided the patients into two groups, group 1, without history of cardiac failure, and group 2, with history of cardiac failure, and looked for differences between the groups in later adverse outcome. cTnT was measured using the Enzymun((R)) troponin T assay on an ES 700 analyzer (Roche). cTnI was measured on a Stratus((R)) II analyzer (Dade Behring). Creatinine and blood urea nitrogen were measured on a Vitros((R)) 950 IRC (Ortho). RESULTS: Dialysis acutely increased cTnT (P: <0.01) and decreased cTnI (P: <0.001) regardless of the dialysis membrane used. Although statistically not significant, cTnT but not cTnI was increased more frequently in group 2 than in group 1, in some cases over the whole study period. Five patients (8.5%) died of cardiac complications within 2 years; all of them had mostly increased cTnT and, in one or more samples, increased cTnI. CONCLUSIONS: Dialysis alters measured cTnT and cTnI concentrations in serum. In patients suffering from end-stage renal failure, sporadic or persistently increased cTnT and cTnI appear to predict cardiac complications. Because of the effects of the dialysis procedure on troponin values, we recommend that blood be collected before dialysis.     

cTnT与CK--MB在胸痛危险分层中的作用

目的评价心肌肌钙蛋白T(cTnT)与肌酸激酶同工酶-MB(CK-MB)蛋白量在胸痛危险分层中的作用。方法对所有病例进行12h床边动态监测，包括基线、4、8、12h的连续心律监测和12导联心电图(ECG)测试；与此同时分别于基线、4、8、12h对入选胸痛组的其中383例患者测定cTnT、CK-MB。结果383例CPU患者只有8例(2．1％)CK-MB阳性，39例cTnT阳性。cTnT状态与随访的结果表明，cTnT阳性明显早于CK-MB。89％cTnT阳性患者血管造影术显示发生冠状动脉疾病(CAD)及多支血管病。结论cTnT比CK-MB在评估伴心肌坏死和多支血管病的胸痛危险分层中具有更高的敏感性与特异性；常规测定cTnT更便于胸痛的危险分层与处理。     

Improved assay of cardiac troponin I is more sensitive than other assays of necrosis markers

OBJECTIVE: Highly sensitive and specific assays of cardiac troponins I and T are the preferred biomarkers in diagnosing myocardial infarction (MI). Assays of cardiac troponin I (cTnI) have been improved with the addition of antibodies against the cTnI molecule and may have increased sensitivity. We hypothesized that a cTnI assay with modern antibody configuration will exhibit equal or better sensitivity in the setting of acute MI compared to cTnT and other markers of myocardial necrosis. MATERIAL AND METHODS: We investigated release kinetics of cTnI (Abbott ADV, Abbott Diagnostics), cTnT (Roche Diagnostics), CKMBmass, myoglobin and heart fatty acid binding protein (H-FABP) in 23 patients admitted with acute ST-segment elevation MI undergoing primary percutaneous coronary intervention. Calibrators for the Abbott ADV cTnI assay are traceable to the United States National Institute of Standards and Technology (NIST) reference material for cTnI. Eleven blood samples were drawn from each patient in the period from admission to 24 h. Biomarkers of necrosis showed marked increases in relative concentrations, especially within the first 2 h after admission. RESULTS: From 30 min after admission onwards, cTnI exhibited significantly higher relative concentrations compared to cTnT, CKMBmass, Myoglobin and H-FABP (p<0.05). CONCLUSIONS: The NIST standardized Abbott TnI ADV assay appears to be more sensitive than cTnT and other biomarkers in the early phase of MI.     

Cardiac troponin T and creatine kinase MB are not increased in exterior oblique muscle of patients with renal failure

BACKGROUND: Serum cardiac troponin T (cTnT) concentrations may be increased in patients with renal dysfunction without evidence of cardiac damage, as assessed by conventional methods. It has been suggested that these positive measurements result from the expression in skeletal muscle of fetal isoforms of cTnT, which are detected by the cTnT immunoassay. METHODS: Skeletal muscle (exterior oblique) biopsies were taken from healthy living kidney donors (n = 5) and transplant recipients (n = 19). The amounts of cTnT and creatine kinase (CK) isoenzymes in skeletal muscle of healthy controls were compared with those in patients with renal failure (Wilcoxon-Mann-Whitney test). cTnT was measured quantitatively by a second-generation assay, with a limit of detection of 1 microg/g of protein, and qualitatively by immunohistochemistry and immunoblotting. CK-MB was measured by quantitative electrophoresis. RESULTS: Minute quantities of cTnT were detected in 2 of the 5 (40%) control samples and 9 of the 19 (47%) renal failure samples, respectively, at mean concentrations of <5 microg/g of protein for both subject groups. This was <1/6000th that found in heart muscle. There was no significant difference in cTnT or CK-MB content in skeletal muscle between healthy controls and patients with renal failure. Increased serum cTnT did not predict detectable cTnT in skeletal muscle. cTnT was not detected qualitatively by immunoblotting or immunohistochemistry in any skeletal muscle samples. CONCLUSIONS: Uremia does not affect the content of cTnT or CK-MB in exterior oblique muscle, suggesting that cTnT detected in serum from patients with renal failure does not originate from skeletal muscle.     

Cardiac troponin and beta-type myosin heavy chain concentrations in patients with polymyositis or dermatomyositis

Cardiac troponin T (cTnT), cardiac troponin I (cTnI), myosin heavy chains (MHC), myoglobin, creatine kinase (CK), and creatine kinase isoenzyme MB (CKMB), were measured in blood samples from 39 polymyositis (PM) or dermatomyositis (DM) patients without clinical evidence for cardiac involvement to evaluate their clinical usefulness in this patient population. MHC, myoglobin, and CKMB were frequently elevated and correlated with each other and with disease severity. Undetectable cTnI in all but one patient indicated that MHC was released from skeletal muscle, thereby providing the first laboratory evidence of frequent slow-twitch muscle fibre-necrosis in patients with PM or DM. CKMB was elevated in 51%, cTnT in 41%, and cTnI in only 2.5% of patients. cTnI did not correlate with other markers or with disease severity scores. The close correlations found between cTnT and skeletal muscle damage markers and the relationship between cTnT with disease severity without clinical evidence for myocardial damage suggest a release of cTnT from skeletal muscle. The relationship of cTnT with disease severity indicates a possible role of the marker for risk stratification. However, the prognostic values of cardiac troponins and other muscle damage markers in PM/DM patients remain to be compared in prospective outcome trials.     

充血性心力衰竭患者血清肌钙蛋白T、肌钙蛋白Ⅰ检测及临床分析

目的研究充血性心力衰竭患者血清肌钙蛋白T(cTnT)和肌钙蛋白Ⅰ(cTnI)水平与心功能的关系及其对预后的判断。方法检测110例不同病因、不同心功能分级的充血性心力衰竭患者的cTnT、cTnI及左室射血分数(LVEF),并与40名健康对照组的结果进行比较。结果心功能Ⅱ级组cTnT为(78.56±25.65)pg/mL,cTnI为(0.85±0.57)ng/mL,LVEF值为57.46%±4.42%;心功能Ⅲ级分别为(249.25±76.21)pg/mL、(3.75±1.83)ng/mL、44.27%±10.13%;心功能Ⅳ级组分别为(375.62±81.29)pg/mL、(8.57±2.56)ng/mL、36.75%±5.66%,与健康对照组[分别为(3.65±0.96)pg/mL、(0.02±0.01)ng/mL、65.52%±8.01%]比较,差异有统计学意义(P<0.01),且心功能越差,cTnT、cTnI浓度越高;cTnT、cTnI与LVEF值均呈负相关,r分别为-0.487、-0.360,差异有统计学意义(P<0.01)。结论检测cTnT、cTnI对于判断充血性心力衰竭患者病情严重程度及预后具有重要的临床价值,是早期评估患者风险的重要方法。     

运动后大鼠血清中相关酶学变化的比较研究

目的通过检测运动后大鼠血清心肌肌钙蛋白I(cTnI)和磷酸肌酸激酶(CK),磷酸肌酸激酶同工酶(CK-MB),乳酸脱氢酶(LDH)并将它们进行比较,以期探讨它们在运动医学中的应用价值。方法38只SD大鼠分为对照组,游泳力竭后即刻组,游泳4.5h后6h,18h,24h组,分别测定其血清cTnI,CK,CK-MB,LDH。cTnI检测用改良Bodor双抗夹心酶联免疫法。CK-MB测定用免疫抑制法。结果①游泳力竭后即刻组,大负荷运动后6,18,24h组cTnI的OD值与对照组相比,t=1.567,ν=13,P=0.141;F=1.393,P=0.267,组间P值0.061～0.897,显示差异均无显著性。②游泳力竭后即刻组CK,CK-MB,LDH升高,与对照组相比,t值分别为4.027,10.666,9.413,P值均<0.01,差异有显著性。③大负荷运动后6h组CK,CK-MB,LDH升高,与对照组相比,P值分别是0.044,0.015,0.019,P值均<0.05,差异有显著性。结论①游泳力竭后即刻CK,CK-MB,LDH升高,但cTnI未有升高,尚需进一步动态检测cTnI。②大负荷运动后,动态检测未见有血清cTnI升高,提示未有心肌损伤。③大负荷运动后6h组出现的CK,CK-MB,LDH升高是否表明有心肌损伤应重新认识。     

Serum cardiac troponin T levels as an indicator of myocardial injury in ischemic and hemorrhagic stroke patients

Many studies in the literature have clearly shown the increase in creatine kinase-myocardial subfraction (CK-MB) levels and changes in electrocardiography (ECG) after stroke. However, the studies on cardiac troponin T (cTnT) which is more sensitive and specific to myocardium after stroke are relatively scarce. Moreover, its associations with volume of stroke lesions and type of stroke have not been investigated thoroughly. Thus, the aims of this study were to investigate a predictive value of cTnT in assessing myocardial injury and cardiac dysfunction in different types of stroke (hemorrhagic or ischemic stroke) and its relationship with stroke size and volume. This study included 62 patients (30 males and 32 females) with acute stroke confirmed by computed tomography (CT). Blood samples were obtained within 24 hours of stroke onset to measure the serum levels of creatin kinase (CK), CK-MB, lactate dehydrogenate (LDH), and cTnT. ECG and echocardiography were performed to assess myocardial function and left ventricular ejection fraction (LVEF). Of all patients included in the study, 20 patients (32%) demonstrated elevations in cTnT, while 28 patients (45%) had increased CK-MB levels. Serum levels of cTnT were positively correlated with stroke volume (r = 0.65, p < 0.0001), while inversely correlated with LVEF (r = -0.53, p < 0001). Serum levels of both CK-MB and cTnT were higher in patients with hemorrhagic stroke than those with ischemic stroke but this difference was not significant (p > 0.05). As a conclusion, cTnT has a higher specificity and sensitivity in detecting myocardial injury after stroke of both ischemic and hemorrhagic origins. Measurement of the serum levels of cTnT is of clinical importance in evaluating myocardial injury and provides a useful aid in estimating the volume of stroke lesions.