Clinical use of cardiac troponin for acute cardiac care and emerging opportunities in the outpatient setting

Yader Sandoval, Korosh Sharain, Amy K. Saenger, Stephen W. Smith, Fred S. Apple, Allan S Jaffe

Research output: Contribution to journalReview article

1 Scopus citations

Abstract

Cardiac troponin (cTn) testing has evolved significantly in recent times. Because of increased sensitivity, its use has shifted from a marker used to help diagnose acute myocardial infarction (MI) to a marker than can be used in the outpatient setting, as well as for both detection of myocardial injury and risk-stratification. Its main role remains in the diagnosis of acute MI and the risk-stratification of patients presenting with suspected acute coronary syndrome. The analytical improvements in assays leading to precise high-sensitivity cTn assays have contributed to the development of numerous strategies to identify patients at both low- and high-risk for acute MI within a few hours. These approaches should reduce overcrowding in the emergency room and expedite triaging. The ability of measuring cTn in most patients using high-sensitivity (hs) assays has allowed for the opportunity to examine its use in the detection of cardiotoxicity in patients undergoing chemotherapy, as well as exploring the application in both primary and secondary prevention of coronary artery disease. This particular field of research has become increasingly complex, partly due to the numerous cTn assays available (I and T; point-of-care, contemporary, hs) and an array of approaches in which one can use the test. The purpose of this document is to summarize the analytical and clinical information relevant to cTn assays, in particular, hs-cTn assays, and describe present and future opportunities for use of cTn in acute cardiac care and in the outpatient setting.

Original languageEnglish (US)
Pages (from-to)139-156
Number of pages18
JournalMinerva Medica
Volume110
Issue number2
DOIs
StatePublished - Apr 1 2019

Keywords

  • Myocardial infarction
  • Myocardial reperfusion injury
  • Troponin

ASJC Scopus subject areas

  • Medicine(all)

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