High Sensitivity Troponins: A Step Forward or an Unrequested Complication?

摘要

In the last 10 years cardiac troponin (cTn) has been identified as the preferred biomarker for acute myocardial infarction (AMI) because of its specificity for cardiac muscle and its diagnostic sensitivity. The introduction of new assays for measurement of cTn, called high sensitive troponin (hs-Tn), has led to an earlier and more accurate diagnosis of AMI and improved risk stratification in patients with non ST-elevation acute coronary syndromes (NSTE-ACS) but, at the same time, has introduced the problem of a lower diagnostic specificity. The reduced specificity of hs-Tn for AMI may, therefore, lead to an increased number of inappropriate hospitalization, i.e. patients with high cTn due to no-ACS conditions, and requires a more careful evaluation. Several approaches have been proposed to overcome this issue, including use of delta changes and use of different decision limits according to age and sex.