State of the Art-High-Sensitivity Troponins in Acute Coronary Syndromes

Cardiol Clin. 2020 Nov;38(4):471-479. doi: 10.1016/j.ccl.2020.06.001. Epub 2020 Sep 13.

Abstract

In cases of suspected acute coronary syndrome (ACS), rapid and accurate diagnosis is essential to establish effective evidence-based medical treatment. Patients' history, clinical examination, 12-lead electrocardiogram, and cardiac biomarkers are cornerstones in initial management. Since high-sensitivity cardiac troponins were established, they have markedly expedited and revolutionized rule-in and rule-out pathways of patients with ACS and changed our everyday clinical practice. Thus, they have become an indispensable tool in daily routine in emergency units. This review focuses on historical and contemporary standards in laboratory biomarkers of myocardial injury and discusses their implication in the context of the updated universal definition of myocardial infarction.

Keywords: Acute coronary syndrome; Biomarker; High-sensitivity troponin; Myocardial infarction; Myocardial injury.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / blood
  • Acute Coronary Syndrome / diagnosis*
  • Biomarkers / blood*
  • Diagnosis, Differential
  • Humans
  • Myocardial Infarction / blood
  • Myocardial Infarction / diagnosis*
  • Sensitivity and Specificity
  • Troponin / blood*

Substances

  • Biomarkers
  • Troponin