Sensible use of high-sensitivity troponin assays

Abstract

The first intracellular Ca2+ -sensor protein to be described was the troponin complex. Only later it was discovered that cardiac-speci fic isoforms of troponin I (cTnI) and troponin T (cTnT) exist, and nowadays, measurement of cardiac troponins is a corner stone in the diagnosis of patients with acute coronary syndrome (ACS). High-sensitivity (hs-) assays have been developed that can record slightly elevated plasma concentrations of cardiac troponins as early as 3 h after onset of clinical symptoms. International guidelines de fined a diagnostic cut-offat cardiac troponin levels corresponding to the 99th percentile of a healthy reference population and require that hs-assays measure this concentration with an interassay coef ficient of variation ≤10%. This review provides an overview of the diagnostic and prognostic use of cardiac troponins.