Beyond myocardial infarction: Point-of-care cardiac troponin biosensors for heart failure prognosis and remote monitoring

Heart failure (HF) is a long-term condition that often causes repeated hospital visits and requires close monitoring. Cardiac troponin I (cTnI) and cardiac troponin T (cTnT) are widely known as markers of myocardial infarction, but in HF they can also show ongoing heart-muscle injury, disease progression, and poor prognosis. This review examines the clinical value of repeated troponin measurements and the development of point-of-care testing (PoCT) biosensors for faster and more accessible monitoring. It covers electrochemical immunosensors, aptamer-based sensors, electrochemiluminescence (ECL) systems, field-effect transistor (FET) devices, and emerging wearable and microfluidic platforms. The review also discusses post-discharge follow-up, remote care, and combined interpretation with B-type natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiogram (ECG), kidney function, symptoms, and wearable data. Artificial intelligence (AI) may support patient-specific trend analysis and early risk alerts. However, major challenges remain, including low-level sensitivity, whole-blood testing, assay differences, signal drift, false alarms, and limited validation in real HF patients. Future progress will require reliable devices, clear clinical pathways, and outcome-based studies.