High-Sensitivity Cardiac Troponin Assays: From Implementation to Resource Utilization and Cost Effectiveness

Hong-Kee Lee; Cian P McCarthy; Allan S Jaffe; Richard Body; Ahmed Alotaibi; Yader Sandoval; James L Januzzi Jr

doi:10.1093/jalm/jfae161

High-Sensitivity Cardiac Troponin Assays: From Implementation to Resource Utilization and Cost Effectiveness

J Appl Lab Med. 2025 Feb 5:jfae161. doi: 10.1093/jalm/jfae161. Online ahead of print.

Authors

Hong-Kee Lee^{1

2}, Cian P McCarthy³, Allan S Jaffe^{4

5}, Richard Body⁶, Ahmed Alotaibi^{6

7

8}, Yader Sandoval^{9

10}, James L Januzzi Jr^{3

11}

Affiliations

¹ Department of Pathology and Laboratory Medicine, Endeavor Health, Evanston, IL, United States.
² Department of Pathology, University of Chicago Pritzker School of Medicine, Chicago, IL, United States.
³ Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
⁴ Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States.
⁵ Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States.
⁶ Department of Emergency Medicine, University of Manchester, Manchester, United Kingdom.
⁷ Emergency Medical Services Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
⁸ King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
⁹ Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, United States.
¹⁰ Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, MN, United States.
¹¹ Heart Failure and Biomarker Trials, Baim Institute for Clinical Research, Boston, MA, United States.

PMID: 39907688
DOI: 10.1093/jalm/jfae161

Abstract

Background: Cardiac troponin is the gold-standard biomarker for the evaluation of patients with suspected acute myocardial infarction (MI). Improvements in assay technology have led to high-sensitivity cardiac troponin assays that, when incorporated into accelerated diagnostic pathways, may rapidly diagnose or exclude acute MI more efficiently than conventional troponin assays.

Content: In this narrative review, we provide practical suggestions for implementing high-sensitivity cardiac troponin assays, review accelerated diagnostic pathways incorporating these assays, and review the impact of these assays on resource utilization and cost-effectiveness in relation to the evaluation of individuals with possible acute MI.

Summary: An increasing number of hospitals are transitioning to high-sensitivity cardiac troponin assays. This narrative review provides an overview of the potential benefits of this transition.

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