Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

ACUTE CORONARY SYNDROMES

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

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.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

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

    Article  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    Article  CAS  Google Scholar 

  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).

    Article  Google Scholar 

  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).

    Article  CAS  Google Scholar 

  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).

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  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).

    Article  Google Scholar 

  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).

    Article  CAS  Google Scholar 

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

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christian W. Hamm.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Keller, T., Hamm, C.W. High-sensitivity cardiac troponin assays: finally ready for prime time?. Nat Rev Cardiol 16, 135–136 (2019). https://doi.org/10.1038/s41569-018-0122-9

Download citation

  • Published:

  • Issue Date:

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

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing