What will Change with Highly Sensitive Troponin Assays?

In the not too distant future, high-sensitivity cardiac troponin assays will be introduced for use in the United States. They bring with them many exciting new opportunities within cardiovascular practice including the ability to confirm or refute a diagnosis of acute myocardial infarction more rapidly as well as the ability to risk stratify and guide treatment decisions in patients with a variety of acute and chronic noncoronary diseases. However, clinicians and researchers must be aware of the new facets introduced with troponin testing and, in particular, the new issues that will arise with high sensitivity assays. Emphasis must also be placed on reiterating the same principles of the effective use of troponin testing that applied to conventional assays, as these are likely to become even more important. This review outlines a number of important issues related to high sensitivity assays with a focus on their use in acute hospital settings.