Troponin: an important prognostic marker and risk-stratification tool in non–ST-segment elevation acute coronary syndromes

Over the past decade, there has been a progressive evolution of cardiac marker testing in patients with acute coronary syndromes (ACS). This has not only resulted in a dramatic shift in how we view the diagnosis of myocardial infarction (MI), but it has also extended the role of cardiac marker testi...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2003-02, Vol.41 (4), p.S31-S36
Main Authors: Newby, L.Kristin, Goldmann, Britta U., Ohman, E.Magnus
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Angina pectoris
Biomarkers - blood
Cardiology
Cardiovascular disease
Coronary vessels
Electrocardiography
Heart attacks
Heparin, Low-Molecular-Weight - therapeutic use
Humans
Mortality
Myocardial Infarction - blood
Myocardial Infarction - diagnosis
Myocardial Infarction - drug therapy
Myocardial Infarction - mortality
Prognosis
Randomized Controlled Trials as Topic
Risk Assessment
Sensitivity and Specificity
Troponin - blood
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Summary:Over the past decade, there has been a progressive evolution of cardiac marker testing in patients with acute coronary syndromes (ACS). This has not only resulted in a dramatic shift in how we view the diagnosis of myocardial infarction (MI), but it has also extended the role of cardiac marker testing into risk stratification and guidance of treatment decisions. By the year 2000, the development of highly sensitive and cardiac-specific troponin assays had resulted in a consensus change in the definition of MI, placing increased emphasis on cardiac-marker testing with troponins as the new gold standard. Furthermore, and perhaps more importantly, the role of the troponins as superior markers of subsequent cardiac risk in ACS patients became firmly established. Most recently, the supportive role of these markers in identifying patients with ACS who may derive particular benefit from potent anti-thrombotic and anti-platelet therapy or early invasive treatment strategies has been demonstrated. This paper will review the evolution of these important roles of troponin testing for risk stratification in ACS.
ISSN:0735-1097
1558-3597
DOI:10.1016/S0735-1097(02)02832-2