Will a Better Understanding of High-Sensitivity Troponin Assays Help Diagnose, Triage Patients?

An understanding of the diagnostic and prognostic utility of high-sensitivity cardiac troponin (hs-cTn) assays may help clinicians better diagnose and triage patients appropriately, according to a review paper published March 8 in the Journal of the American College of Cardiology.

Inbar Raber, MD, et al., provide an overview of hs-cTn assays and discuss the interpretation and prognostic value of hs-cTn in various clinical scenarios, including the emergency department; normal populations; and patients with stable coronary artery disease (CAD), heart failure (HF) and chronic kidney disease (CKD).

According to the authors, improvements in assays "create avenues for other applications where troponin release from the cardiomyocyte might confer prognostic information" for non-myocardial infarction conditions. The authors provide context for interpreting hs-cTn assays depending on the application, reviewing results from studies leveraging hs-cTn for applications beyond "acute myocardial infarction diagnostic evaluation."

Moving forward, hs-cTn may have a role in guiding statin therapy, initiating antihypertensive agents, and predicting and preventing incident diabetes and HF, the authors note, adding that clinical trials are needed to explore the role of hs-cTn in preventive therapies.

"As hs-cTn use becomes more widespread, physicians are likely to encounter detected levels of hs-cTn in common clinical scenarios, such as among patients with stable CAD, CKD, and HF," the authors note, concluding that a better understanding of the diagnostic and prognostic utility can help clinicians better diagnose and triage patients appropriately.

Clinical Topics: Dyslipidemia, Heart Failure and Cardiomyopathies, Atherosclerotic Disease (CAD/PAD), Nonstatins, Novel Agents, Statins, Acute Heart Failure

Keywords: Antihypertensive Agents, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Troponin, Coronary Artery Disease, Myocytes, Cardiac, Myocardial Infarction, Heart Failure, Cardiology, Renal Insufficiency, Chronic, Diabetes Mellitus

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