Troponin is considered the most reliable biomarker for detecting myocardial injury because it is specifically released when there is damage to cardiac muscle cells. Troponins, particularly troponin I and troponin T, have a high specificity for cardiac tissue, making them excellent indicators of myocardial infarction (heart attack) and other types of cardiac injury.
When cardiac muscle is injured, troponin levels rise in the bloodstream, often within a few hours of the injury, and can remain elevated for days. This property allows healthcare providers to accurately diagnose myocardial injury and assess the severity of the event.
Other biomarkers, while useful in certain contexts, do not offer the same level of specificity for cardiac damage. B-type natriuretic peptide (BNP) is more associated with heart failure than direct myocardial injury. Creatine kinase can indicate muscle damage more generally, not exclusively from the heart, and is less specific than troponin. Lactate dehydrogenase (LDH) is also a less specific marker, as it can be elevated in various conditions unrelated to myocardial injury. Therefore, the specificity and sensitivity of troponin make it the preferred choice for assessing cardiac damage in clinical settings.