Troponin basics for clinicians

Cardiac troponin (cTn) is the preferred biomarker for the diagnosis of acute myocardial infarction (AMI), including each specific MI subtype (i.e., type 1-5 acute myocardial infarction), due to cTn’s high myocardial tissue specificity and high clinical sensitivity [1]. cTn are regulatory proteins with both cytosolic (predominant) and structural pools (minor) [2]. Clinical implementation of cTnT and cTnI assays in the late 1980s revolutionized the diagnostic approach of patients with symptoms suspicious for AMI [3, 4]. Global utilization of high-sensitivity (hs) cTnI and cTnT assays has brought upon clinicians another transformational stage in the diagnostic approach of patients presenting with symptoms suspicious for AMI. It is essential for clinicians, in particular emergency physicians and cardiologists, to understand the nuances of cTn testing, as proper understanding of the analytical characteristics of assays will lead to sound clinical implementation and improved research observations.