Abstract
Cardiac troponins (cTn) are considered to be the ‘gold standard’ biomarker for the diagnosis of acute coronary syndrome (ACS); a pathological spectrum which includes cardiac ischemia, angina, myocardial infarction and ultimately cardiac failure. The growing evidence base for the diagnostic and prognostic use of cTn in ACS has resulted in a universal redefinition of acute myocardial infarction (AMI). Recently a number of immunoassays with claims of superior sensitivity have been produced. The analytical and clinical performance of these assays require appropriate evaluation. Sensitive assays can be used for diagnosis in the first few hours after an ischemic episode. Early elevations in cTn are prognostic. A single time point for cTn testing may be useful for rule out, however such a strategy does not detect the rising and falling pattern required for diagnosis as suggested in the universal definition of AMI. The newer assays demonstrate low level cTn positivity in apparently healthy people. In addition, the sensitive assays detect more cTn positive patients who do not have a final diagnosis of ACS. It is unknown if such mild elevations in cTn detected by sensitive assays are of clinical concern. What is certain is that AMI remains a clinical not a biochemical diagnosis and interpretation of cTn concentrations should be made according to the clinical context. This review highlights the development of the sensitive assays, documents their analytical and clinical performance and reviews the usefulness of cTn elevation in non-ACS conditions.
Keywords: Acute coronary syndrome, cardiac troponin, exercise, sensitivity, (cTn), cardiac ischemia, angina, myocardial infarction, ultimately cardiac, immunoassays
Current Medicinal Chemistry
Title: The Perils, Pitfalls and Opportunities of Using High Sensitivity Cardiac Troponin
Volume: 18 Issue: 23
Author(s): D.C. Gaze
Affiliation:
Keywords: Acute coronary syndrome, cardiac troponin, exercise, sensitivity, (cTn), cardiac ischemia, angina, myocardial infarction, ultimately cardiac, immunoassays
Abstract: Cardiac troponins (cTn) are considered to be the ‘gold standard’ biomarker for the diagnosis of acute coronary syndrome (ACS); a pathological spectrum which includes cardiac ischemia, angina, myocardial infarction and ultimately cardiac failure. The growing evidence base for the diagnostic and prognostic use of cTn in ACS has resulted in a universal redefinition of acute myocardial infarction (AMI). Recently a number of immunoassays with claims of superior sensitivity have been produced. The analytical and clinical performance of these assays require appropriate evaluation. Sensitive assays can be used for diagnosis in the first few hours after an ischemic episode. Early elevations in cTn are prognostic. A single time point for cTn testing may be useful for rule out, however such a strategy does not detect the rising and falling pattern required for diagnosis as suggested in the universal definition of AMI. The newer assays demonstrate low level cTn positivity in apparently healthy people. In addition, the sensitive assays detect more cTn positive patients who do not have a final diagnosis of ACS. It is unknown if such mild elevations in cTn detected by sensitive assays are of clinical concern. What is certain is that AMI remains a clinical not a biochemical diagnosis and interpretation of cTn concentrations should be made according to the clinical context. This review highlights the development of the sensitive assays, documents their analytical and clinical performance and reviews the usefulness of cTn elevation in non-ACS conditions.
Export Options
About this article
Cite this article as:
Gaze D.C., The Perils, Pitfalls and Opportunities of Using High Sensitivity Cardiac Troponin, Current Medicinal Chemistry 2011; 18 (23) . https://dx.doi.org/10.2174/092986711796642571
DOI https://dx.doi.org/10.2174/092986711796642571 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
Call for Papers in Thematic Issues
Advances in Medicinal Chemistry: From Cancer to Chronic Diseases.
The broad spectrum of the issue will provide a comprehensive overview of emerging trends, novel therapeutic interventions, and translational insights that impact modern medicine. The primary focus will be diseases of global concern, including cancer, chronic pain, metabolic disorders, and autoimmune conditions, providing a broad overview of the advancements in ...read more
Approaches to the treatment of chronic inflammation
Chronic inflammation is a hallmark of numerous diseases, significantly impacting global health. Although chronic inflammation is a hot topic, not much has been written about approaches to its treatment. This thematic issue aims to showcase the latest advancements in chronic inflammation treatment and foster discussion on future directions in this ...read more
Cellular and Molecular Mechanisms of Non-Infectious Inflammatory Diseases: Focus on Clinical Implications
The Special Issue covers the results of the studies on cellular and molecular mechanisms of non-infectious inflammatory diseases, in particular, autoimmune rheumatic diseases, atherosclerotic cardiovascular disease and other age-related disorders such as type II diabetes, cancer, neurodegenerative disorders, etc. Review and research articles as well as methodology papers that summarize ...read more
Chalcogen-modified nucleic acid analogues
Chalcogen-modified nucleosides, nucleotides and oligonucleotides have been of great interest to scientific research for many years. The replacement of oxygen in the nucleobase, sugar or phosphate backbone by chalcogen atoms (sulfur, selenium, tellurium) gives these biomolecules unique properties resulting from their altered physical and chemical properties. The continuing interest in ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Echocardiographic Hemodynamic Monitoring in the Critically Ill Patient
Current Cardiology Reviews Extracellular Enzymes Production and Biofilm Formation in Rhodotorula Species
Current Enzyme Inhibition Cardiovascular Implantable Electronic Device Infections: Risk Scoring and Role of Antibiotic Envelope in Prevention
Recent Advances in Cardiovascular Drug Discovery (Discontinued) Endocarditis Due to Salmonella Enterica Subsp. Arizonae in a Patient with Sickle Cell Disease: A Case Report and Review of the Literature
Cardiovascular & Hematological Disorders-Drug Targets Prospective Evaluation of the Dosing Regimen of Vancomycin in Children of Different Weight Categories
Current Drug Safety Liposome-Nanogel Structures for Future Pharmaceutical Applications
Current Pharmaceutical Design Structure-Function Relationships in Anti-DNA and Anti-Phospholipid Antibodies and their Relevance to the Pathogenesis of Disease
Current Rheumatology Reviews Special Features of Gram-Positive Bacterial Eradication by Photosensitizers
Recent Patents on Anti-Infective Drug Discovery Natural Products Towards the Discovery of Potential Future Antithrombotic Drugs
Current Pharmaceutical Design Comparative Biochemistry of GH3, GH20 and GH84 β-N-acetyl-Dhexosaminidases and Recent Progress in Selective Inhibitor Discovery
Current Drug Targets Current Indications for Infective Endocarditis Antibiotic Prophylaxis
Infectious Disorders - Drug Targets Microbial Biofilms: Impact on the Pathogenesis of Periodontitis, Cystic Fibrosis, Chronic Wounds and Medical Device-Related Infections
Current Topics in Medicinal Chemistry Proteomics Analysis: A Powerful Tool to Identify Proteome Phenotype and Proteome Signature in Enterococcus faecalis
Current Proteomics Systematic Reviews of Animal Experiments Demonstrate Poor Contributions Toward Human Healthcare
Reviews on Recent Clinical Trials Ophthalmological and Otological Manifestations in the Antiphospholipid Syndrome
Current Rheumatology Reviews Nutrition in Infancy
Current Pediatric Reviews Glycoprotein Targeting and Other Applications of Lectins in Biotechnology
Current Protein & Peptide Science HtrA Protease Family as Therapeutic Targets
Current Pharmaceutical Design Prevalence of Nasal Colonization with Staphylococcus aureus in Patients with Rheumatoid Arthritis
Current Rheumatology Reviews Chlorophylls and their Derivatives Used in Food Industry and Medicine
Mini-Reviews in Medicinal Chemistry