High-Sensitivity Cardiac Troponin for the Diagnosis of Patients with Acute Coronary Syndromes.

PURPOSE OF REVIEW: High-sensitivity cardiac troponin (hscTn) assays are replacing the older-generation assays used to detect myocardial injury because they have improved analytical sensitivity and lead to a more rapid diagnosis of acute myocardial infarction (AMI) and enhanced risk stratification in patients with non-ST elevation acute coronary syndromes (NSTE-ACS). This review focuses on advantages and difficulties of using hscTn as diagnostic and prognostic tools in acute coronary syndromes (ACS).

RECENT FINDINGS: The newer assays have a lower specificity for AMI as compared to conventional assays, potentially leading to an increased number of unwarranted hospitalizations and amplified cost unless how to use these assays appropriately is appreciated. Several approaches can increase the specificity of the high sensitivity assays. This review will present the current literature data regarding the use of hscTn assays and will focus on modalities used to increase the specificity, as well as the advantages and pitfalls of using the high sensitivity approach in clinical practice.