High sensitivity troponins in contemporary cardiology practice: are we turning a corner?

ABSTRACT

Introduction: Troponin is considered to be the gold standard biomarker for ruling out MI. There has been a drive to improve the diagnostic speed, and as such the high sensitivity cardiac troponin (hs-cTn) assays have been introduced into clinical practice and are now part of international guidelines. Their novel value in clinical practice more generally is becoming apparent.

Areas covered: In this review we will evaluate the evidence for the use of hs-cTn assays in clinical practice, the issues with the assay and how the hs-cTn can be utilized in the future as a biomarker of cardiovascular risk.

Expert commentary: The use of the hs-cTn assays as a ‘rule out’ test for MI is compelling, as a ‘rule in’ there are significant issues relating the specificity of the assay for MI. The future of the assay may lie in population screening and risk modeling.

KEYWORDS:

• Troponin
• high sensitivity troponin
• myocardial infarction
• acute coronary syndromes
• type 2 myocardial infarction
• type 1 myocardial infarction

Declaration of Interest

Nick Curzen has unrestricted research grants from: Boston Scientific; Haemonetics; Heartflow; Medtronic; speaker fees/consultancy from: Haemonetics, St Jude Medical, Abbot Vascular; Heartflow; Boston Scientific; Travel sponsorship – Biosensors, Abbot, Lilly/D-S; St Jude Medical. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.