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Risk prediction of cardio-vascular disease by high sensitive cardiac troponin assays

Per Venge1,*

1Medical Sciences, Uppsala University, Uppsala, Sweden

Risk prediction of cardio-vascular disease by high sensitive cardiac troponin assays

Per Venge

Department of Medical Sciences, Uppsala University

Per.venge@medsci.uu.se

 

The assay in blood of cardiac troponins is the hallmark of biochemical identification of myocardial injury and disease. It is part of the diagnostic criteria of Non ST-elevation Myocardial Infarction (NSTEMI). The sensitivity of cardiac troponin assays has gradually increased and currently assays are available that are able to reproducibly measure troponin in blood of most healthy subjects. This fact has completely changed the view on the clinical utility of troponin assays, since it allows earlier identification of myocardial injury in patients with myocardial infarction than before, but most of all since it has become apparent that even very minor elevations of troponin in blood may signify cardiac abnormalities related to major adverse cardio-vascular events such as AMI or premature death. Such minor elevations are seen not only in diseased populations with known cardiac disease, but also in community-based populations without any apparent history of disease. Some of these minor elevations are related to clinically unidentified myocardial infarctions as demonstrated by sensitive imaging techniques, whereas the origin and cause often is unknown. However, the use of these high sensitive assays has revealed clear gender differences that indicate different underlying mechanisms of the acute coronary syndrome in men and women. The exciting potential of the novel high sensitive cardiac troponin assays is their use in population screening and for primary prevention of cardio-vascular disease.

Keywords: Biomarker, Cardiovascular, Heart