High-sensitivity cardiac
troponin (hs-
cTn) assays are increasingly being used in many countries worldwide, however, a generally accepted definition of high-sensitivity is still pending. These assays enable
cTn measurement with a high degree of analytical sensitivity with a low analytical imprecision at the low measuring range of
cTn assays (coefficient of variation of < 10% at the 99(th) percentile upper reference limit). One of the most important advantages of these new assays is that they allow novel, more rapid approaches to rule in or rule out
acute coronary syndromes (ACSs) than with previous
cTn assay generations which are still more commonly used in practice worldwide. hs-
cTn is also more sensitive for the detection of myocardial damage unrelated to acute
myocardial ischemia. Therefore, the increase in early diagnostic sensitivity of hs-
cTn assays for ACS comes at the cost of a reduced ACS specificity, because more patients with other causes of acute or chronic myocardial injury without overt
myocardial ischemia are detected than with previous
cTn assays. As hs-
cTn assays are increasingly being adopted in clinical practice and more hs-
cTn assays are being developed, this review attempts to synthesize the available clinical data to make recommendations for their everyday clinical routine use.