High-sensitivity cardiac troponin assays for cardiovascular risk stratification in the general population

• Published in: European heart journal Vol. 41; no. 41; pp. 4050 - 4056
• Main Authors: Farmakis, Dimitrios, Mueller, Christian, Apple, Fred S
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.11.2020
• Subjects: Biomarkers; Cardiovascular Diseases - diagnosis; Heart Disease Risk Factors; Humans; Risk Factors; Troponin I; Troponin T; High-sensitivity troponin I; Screening; Cardiac troponin; Risk stratification; Cardiovascular risk
• ISSN: 0195-668X; 1522-9645; 1522-9645
• DOI: 10.1093/eurheartj/ehaa083

Abstract Cardiac troponins (cTns) I and T have long been the most successful cardiac-specific circulating biomarkers in cardiovascular (CV) medicine, having changed dramatically the diagnosis of acute myocardial infarction, while being independent predictors of outcome in several cardiac conditions and non-cardiac conditions. The latest-generation high-sensitivity (hs) cTn assays demonstrate both enhanced diagnostic performance and improved analytical performance, with the ability to measure detectable concentrations in a substantial proportion of the asymptomatic and presumably healthy populations. Given this unique analytical feature, recent evidence suggests that hs-cTn can be used for the stratification of CV risk in the general population. High-sensitivity cTn predicts future CV events, are responsive to preventive pharmacological or lifestyle interventions, change in parallel to risk modifications, and offer incremental risk prediction when added to well-established prognosticators. The implementation of CV risk stratification and prevention strategies incorporating hs-cTn requires further investigation to define the optimal target populations, timing of measurement, and preventive interventions.