High-sensitivity cardiac troponin assay in predicting mortality?

Recent studies have shown that the high-sensitivity cardiac troponin assay can substantially improve early diagnosis of acute myocardial infarction and allow risk stratification of patients with stable congestive heart failure and acute coronary syndromes. An important recent study involving patients with stable coronary artery disease enrolled in the Prevention of Events with Angiotensin Converting Enzyme Inhibition Trial showed that elevated cardiac troponin T levels, measured with a high-sensitivity troponin assay, were significantly associated with the increased incidence of cardiovascular death. However, exclusion criteria consequent on the primary study design on angiotensin-converting enzyme inhibition produced a selected population that, among others, did not include patients who had a recent or planned revascularization procedure.

References:
1. Keller T., Zeller T., Peetz D., et al: Sensitive troponin I assay in early diagnosis of acute myocardial infarction. N Engl J Med 361. 868-877.2009;
2 Reichlin T., Hochholzer W., Bassetti S., et al: Early diagnosis of myocardial infarction with sensitive cardiac troponin assays. N Engl J Med 361. 858-867.2009;