Cardiac troponin is the standard biomarker for detection of myocardial injury. An increase of cardiac troponin >99th percentile by use of a sufficiently sensitive and precise assay is required to diagnose acute myocardial infarction (MI)1 and is increasingly measured by use of high-sensitivity cardiac troponin T (hs-cTnT) and hs-cTnI assays outside the US. In patients with stable coronary artery disease (SCAD), hs-cTnT can be detected in >80% of patients (1), with values above the 99th percentile in approximately 11% of patients (2). Increasing concentrations of hs-cTnT and hs-cTnI above the 99th percentile are also associated with an increased risk of adverse cardiovascular events (2, 3). The mechanisms underlying cardiac troponin increase remain unclear, but may include silent plaque rupture, inducible ischemia, anatomic burden of CAD, cardiac structural abnormalities, or impaired left ventricular (LV) function (4, 5).
Publication information
de Silva R, Tsujioka T, Gaze D, Banya WAS, Shah BN, Zoppelaro G, Hersey J, Gonzalez AM, Collins P, Collinson PO, Senior R, Fox KM. Exercise induced changes high sensitivity cardiac troponin and heart fatty acid binding protein in patients with suspected angina pectoris. Clin Chem 2015;61:554-6.