High-Sensitivity Troponin for Population-Level Cardiovascular Risk Screening
High-sensitivity cardiac troponin assays can now accurately measure cTnI and cTnT in reference populations, revealing associations between troponin concentrations within normal reference intervals and future major cardiovascular events. These assays enable monitoring of subclinical myocardial remodeling and early identification of individuals at highest risk for heart failure progression. While the potential for population-level screening is compelling, clinical trials demonstrating cost-effectiveness and optimal screening strategies are needed before general implementation can be recommended.
The original study
Evidence on clinical relevance of cardiovascular risk evaluation in the general population using cardio-specific biomarkers.
- Authors
- Clerico A, Zaninotto M, Passino C, Aspromonte N, Piepoli MF, Migliardi M, et al.
- Journal
- Clinical chemistry and laboratory medicine
- Type
- Journal Article, Review
- PMID
- 32692693
Original abstract
In recent years, the formulation of some immunoassays with high-sensitivity analytical performance allowed the accurate measurement of cardiac troponin I (cTnI) and T (cTnT) levels in reference subjects. Several studies have demonstrated the association between the risk of major cardiovascular events and cardiac troponin concentrations even for biomarker values within the reference intervals. High-sensitivity cTnI and cTnT methods (hs-cTn) enable to monitor myocardial renewal and remodelling, and to promptly identify patients at highest risk ofheart failure. An early and effective treatment of individuals at higher cardiovascular risk may revert the initial myocardial remodelling and slow down heart failure progression. Specific clinical trials should be carried out to demonstrate the efficacy and efficiency of the general population screening by means of cost-benefit analysis, in order to better identify individuals at higher risk for heart failure (HF) progression with hs-cTn methods.