Response to Dr. Unal's Letter

To the Editor,

We read the letter written by Unal et al., and we realized the point that they mentioned. During our research we were aware of this stuation. But, since we did not have enough equipment and support, we could not evaluate serum levels of cardiac troponin-I (CTI). Therefore, we could not make any comment on whether serum levels of CTI was interfere with myocardial damage related to carbon monoxide poisoning (COP) or not.

As for the cardiac troponin-T (CTT), higher levels of serum CTT related to myocardial damage in patients with COP were reported by Zhu et al. (2006). While their patients were postmortem, our patients did not die, and our many patients also discharged from the hospital at between 24 and 48 h. In the other study by Aslan et al., serum levels of CTT were slightly elevated in only 1 patient among 40 patients (Aslan et al., 2005). For this reason, we think that the serum levels of CTT could not be elevated from myocardial damage related to COP. In the case of a patient with ST depresion on electrocardiograph (ECG) and decreased left ventricular systolic function (EF < 40%) the situation can be explained as follows: In the detection of myocardial damage, since the specificity of the serum levels of CTT was not 100% (Jaffe et al., 2000), the serum levels of CTT in the mentioned patient might have not been elevated.

As a result, although we completely agree with the reader's opinion that serum levels of CTI must be measured in the evaluation of myocardial damage in COP, we would like to emphasize that the specificity of the serum levels of CTT in the detection of myocardial damage was not 100%.