High Sensitivity Troponins

Emerg Med Clin North Am. 2022 Nov;40(4):809-821. doi: 10.1016/j.emc.2022.07.002. Epub 2022 Oct 7.


High-sensitivity cardiac troponin (hs-cTn) assays are highly specific to cardiac tissue and can detect small amounts of myocardial injury rapidly. Hs-cTn assays are the recommended cardiac biomarkers in the major US and European guidelines. In the appropriate clinical context, these assays allow clinicians to rapidly rule out a non-ST-elevation myocardial infarction and decrease 30-day major adverse cardiac events. This can have significant downstream impacts on the percentage of patients discharged from the emergency department (ED), ED lengths of stay, cardiac testing, and hospitalizations. There are many proposed diagnostic protocols and experts recommend institutions implement a single validated protocol.

Keywords: Acute MI; Acute coronary syndrome; Cardiac biomarkers; Cardiac rule out; Chest pain; Emergency medicine; High-sensitivity troponin; Myocardial infarction.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Emergency Service, Hospital
  • Humans
  • Myocardial Infarction* / diagnosis
  • Troponin*


  • Biomarkers
  • Troponin