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ACUTE CORONARY SYNDROMES

High-sensitivity cardiac troponin assays: finally ready for prime time?

Nature Reviews Cardiologyvolume 16pages135136 (2019) | Download Citation

High-sensitivity cardiac troponin (hs-cTn) assays facilitate the ruling-out of myocardial infarction (MI) but identify a high number of patients with elevated troponin levels but without MI. Consequently, the term myocardial injury was included in the latest universal definition of MI. In the High-STEACS trial, use of a hs-cTnI assay was safe but had no prognostic benefit.

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References

  1. 1.

    Mehta, S. R. et al. Early versus delayed invasive intervention in acute coronary syndromes. N. Engl. J. Med. 360, 2165–2175 (2009).

  2. 2.

    Thygesen, K. et al. Fourth universal definition of myocardial infarction (2018). Eur. Heart J. https://doi.org/10.1093/eurheartj/ehy462 (2018).

  3. 3.

    Keller, T. et al. Sensitive troponin I assay in early diagnosis of acute myocardial infarction. N. Engl. J. Med. 361, 868–877 (2009).

  4. 4.

    Hamm, C. W. et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur. Heart J. 32, 2999–3054 (2011).

  5. 5.

    Mills, N. L. et al. Implementation of a sensitive troponin I assay and risk of recurrent myocardial infarction and death in patients with suspected acute coronary syndrome. JAMA 305, 1210–1216 (2011).

  6. 6.

    Shah, A. S. V. et al. High-sensitivity troponin in the evaluation of patients with suspected acute coronary syndrome: a stepped-wedge, cluster-randomised controlled trial. Lancet 392, 919–928 (2018).

  7. 7.

    Keller, T. et al. Serial changes in highly sensitive troponin I assay and early diagnosis of myocardial infarction. JAMA 306, 2684–2693 (2011).

  8. 8.

    Neumann, J. T. et al. Diagnosis of myocardial infarction using a high-sensitivity troponin I 1-hour algorithm. JAMA Cardiol. 1, 397–404 (2016).

  9. 9.

    Roffi, M. et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur. Heart J. 37, 267–315 (2016).

  10. 10.

    US National Library of Medicine. ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT03005158 (2016).

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Author information

Affiliations

  1. Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany

    • Till Keller
    •  & Christian W. Hamm
  2. German Center for Cardiovascular Research (DZHK), Partner site RheinMain, Bad Nauheim, Germany

    • Till Keller
    •  & Christian W. Hamm
  3. University Hospital, Department of Cardiology, Justus Liebig University, Giessen, Germany

    • Christian W. Hamm

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Competing interests

The authors declare no competing interests.

Corresponding author

Correspondence to Christian W. Hamm.

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DOI

https://doi.org/10.1038/s41569-018-0122-9

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