To T or Not to T, That Is the Question

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Abstract
The quest for a test that is absolutely disease- and tissue-specific could be considered the Holy Grail of the clinical chemist, dreamt of but seldom achieved. Initial reports on measurement of the cardiac troponins, cardiac troponin T (cTnT) and cardiac troponin I (cTnI), for diagnosis of myocardial infarction suggested that these markers would become the “gold standard,” replacing all other existing tests. Questions have been raised as to the specificity of cTnT for cardiac damage in patients with extreme rhabdomyolysis, renal failure, polymyositis, and muscular dystrophy. This problem is addressed by the papers of Bodor et al. (1) and Müller-Bardorff et al. (2) in this issue of Clinical Chemistry. This is therefore a reasonable time to review what we know at the basic science level and how this relates to both papers and current clinical practice.