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 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.
Newby
L Kristin
LK
Duke Clinical Research Institute, Durham, North Carolina, USA.
Goldmann
Britta U
BU
Ohman
E Magnus
EM
D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014336:Troponin / Q000097:blood*
D015415:Biomarkers; D006495:Heparin, Low-Molecular-Weight; D014336:Troponin