Use of Highly Sensitive Cardiac Troponin I Test outside Acute Coronary Syndrome

typical changes in CK-MB and cardiac troponin in Acute Myocardial Infarction (Photo credit: Wikipedia)

Traditionally, Cardiac Troponin I and highly sensitive cardiac troponin T are used to support the diagnosis of acute coronary events, such as heart stroke or Myocardial Infarction.

A new study has found it’s role outside the Acute Coronary Syndrome (ACS), incase of otherwise stable patients of coronary artery disease (CAD).


Elevated concentrations of cardiac troponin I (cTnI) in patients with stable coronary artery disease (CAD) are associated with an increased risk of cardiovascular death or heart failure, as well as a significantly increased risk of nonfatal MI.
In this new analysis, increases in cTnI, detected using a highly sensitive assay, were associated with an 88% higher risk of cardiovascular death or heart failure and a 44% increased risk of nonfatal MI.
In this study, high-sensitivity cTnI levels were assessed in 3623 patients with stable CAD and preserved systolic function. Of these individuals, 98.5% had cTnI concentrations above the 1.2-pg/mL assay detection limit.

Abbreviations used for ACS (Acute coronary syndrome) (Photo credit: Wikipedia)

Now, as no strategy has been developed on how to utilize the results to modify such risks; it has not been recommended for universal use. But, it is a strong prognostic indicator.
The increase in the level of troponin may be due to stress in cardiac muscle or from stress related hypertrophy of cardiac muscle.