Each new troponin assay generation is more sensitive, with recent generation high-sensitivity troponin (hsTn) assays able to detect minimal myocardial injury, even in asymptomatic patients. PURPOSE OF THE REVIEW: We reviewed recent information on the use of hsTn assays for assessing acute and chronic cardiovascular disease. RECENT FINDINGS: hsTn is used for early emergency department diagnosis, accelerating early discharge with a low event rate comparable if not better than current strategies. Low levels of hsTn are detected in a variety of chronic cardiac and non-cardiac conditions, non-disease conditions including heart failure, chemotherapy, and others. These elevations identify a population at increased risk for long-term cardiovascular events. However, management strategies remain unclear. hsTn has substantial advantages in emergency department use. They hold promise for identifying subclinical cardiac disease, with the potential for earlier intervention with the possibility of decreasing disease progression. Additional studies, however, are needed to determine if this strategy will lead to improved outcomes.
Keywords: Acute myocardial infarction; Congestive heart failure; Diagnosis; Emergency department; High-sensitivity troponin; Myocardial injury.