title: High-sensitivity cardiac troponin in acute conditions.
abstract: OBJECTIVE
  We aim to help clinicians to use and interpret high-sensitivity cardiac troponins (cTns) in different acute care settings. This guidance is timely and relevant as high-sensitivity cTns are currently replacing conventional cTn assays in most parts of the world.
  
  
  RESULTS
  cTn I and T are structural proteins unique to the heart. Detection of cTn in peripheral blood indicates cardiomyocyte injury. Although acute myocardial infarction is a very common, dangerous, but treatable and therefore clinically important cause of cardiomyocyte injury, multiple other acute conditions are associated with substantial amounts of cardiomyocyte injury and corresponding elevations in cTn. These include acute heart failure, tachyarrhythmias, pulmonary embolism, sepsis, shock, and noncardiac surgery. Recent advances in assay technology have led to more sensitive and precise cTn assays that now allow the detection and exact quantification of cardiomyocyte injury also in many predominately noncardiac acute conditions.
  
  
  CONCLUSIONS
  In all of these, elevated levels of high-sensitivity cTn are associated with increased mortality risk. In some of these, concepts are evolving as to how the pathophysiological signal of cardiomyocyte injury could be used to alter patient management and potentially improve outcomes.
authors.affiliation: aDepartment of Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil bDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Gualandro
authors.forename: Christian
authors.initials: C
authors.lastname: Puelacher
authors.forename: Christian
authors.initials: C
authors.lastname: Mueller
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000378:metabolism; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D006333:Heart Failure / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000378:metabolism; D032383:Myocytes, Cardiac / Q000473:pathology*; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000378:metabolism; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D019210:Troponin I / Q000378:metabolism*; D020107:Troponin T / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T