Highly sensitive troponin assays and the cardiology community: a love/hate relationship?

The development of highly sensitive assays for cardiac troponin T (hs-cTnT) and cardiac troponin I (hscTnI) represents the latest technological advance in a field that has witnessed continual progression toward more sensitive and more precise tools for detecting cardiac injury. The hs-cTnT assay, for example, can detect cTnT concentrations 10-fold lower than the current fourth-generation assay, with high precision at the myocardial infarction (MI) detection limit. Despite the potential for such evolution to improve patient care, clinicians, including practicing cardiologists, often find themselves poorly prepared for the introduction of more-sensitive assays, because they fail to consider the implications of increasing sensitivity on the interpretation of the test results. We believe that highly sensitive troponin assays offer new opportunities to improve cardiovascular health, but they also present challenges in the areas in which troponin testing is most commonly used today.