High-Sensitivity Assays for Troponin in Patients with Cardiac Disease !

Troponin is a widely used biomarker in patients with cardiac disease. The use of troponin is well established in patients with suspected acute myocardial infarction (AMI), but troponin measurement is also used in other acute and nonacute settings. In patients with suspected AMI, early decision-making is crucial to allow rapid treatment and further diagnostic evaluation. Current guidelines recommend serial measurements of troponin with a cut-off concentration at the 99th percentile to triage patients in the emergency department.

Newer, high-sensitivity assays for troponin enable the detection of distinctly lower concentrations. Using these assays and very low cut-off concentrations, several rapid diagnostic strategies have been reported to improve diagnosis in acute cardiac care. Furthermore, noncoronary and non-acute applications of troponin assays — for example as a biomarker in patients with heart failure, pulmonary embolism, or stable coronary artery disease — are on the horizon and might improve individual risk stratification.

In this Review, we provide an overview on the development of high-sensitivity assays for troponin, and their application in patients with cardiac disease.

Pathophysiological background of troponin and troponin release

in different settings. A schematic overview of myocardial structure

related to troponin (inset), as well as the plasma troponin concentrations 

in different clinical settings (young and healthy, elderly or chronic diseases,

myocardial injury, and myocardial infarction).

Read more: High-Sensitivity Assays for Troponin in Patients with Cardiac Disease !

Source: NatureReviewsCadiology

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Cardiovascular Disease Diagnostics and Testing

Current and emerging cardiac markers signal improved testing for better patient outcomes

Cardiovascular diseases continue to be the leading cause of death in the United States, responsible for nearly 800,000 deaths annually—or about one in every three deaths. Heart disease is the leading cause of death for both men and women, claiming the lives of about 610,000 Americans each year.1Coronary artery disease is the most common type of heart disease, killing more than 370,000 people annually.

In addition, about 5.1 million people in the United States have heart failure.2About half of the people who develop heart failure die within 5 years of diagnosis. In 2009, one out of every nine deaths included heart failure as a contributing cause. Heart failure costs the nation an estimated $32 billion each year.

In light of such dire statistics, it’s no wonder that achieving speedy diagnosis of acute myocardial infarction (AMI)—heart attack—remains a significant concern in emergency departments throughout the nation. Early triage of patients to rule-in or rule-out AMI is challenging. For many years, testing for the presence of the regulatory proteins troponin I or troponin T—both released into the bloodstream when the heart muscle has been damaged—has been the gold standard for diagnosing AMI. But recent reports have indicated that the latest generation of high-sensitivity troponin tests can increase diagnostic efficiency and improve early diagnosis of myocardial infarction.

Read more: Cardiovascular Disease Diagnostics and Testing

Alere’s troponin I test is a cartridge-based high-sensitivity immunoassay.

Source: clpmag