The continuing advances in the biochemical research for the discovering an ideal
biomarker for diagnosing myocardial injury have led to discovery cardiac
Troponin, a biochemical gold standard for myocardial
necrosis. Further with advances in the immunoassay techniques, the 99th percentile cutoff value of cardiac
troponin required for the diagnosis of
myocardial infarction decreased, with the latest available ultrasensitive cardiac
troponin assay capable of measuring level as low as 0.005 ng/ml.
Troponin have both diagnostic as well as prognostic significance in myocardial
necrosis, but the cut off value by 99th percentile rule is useful only when applied to patients with a high pretest probability of
Acute Coronary Syndrome(ACS) and also the results must be interpreted in the context of clinical history, ECG findings, and possibly cardiac imaging to establish the correct diagnosis. As cardiac
troponins are also elevated in other cardiac conditions such as cardiomyopaties, the serial monitoring of the cardiac
troponin level along with the absolute value would help to differentiate
myocardial infarction from these many varied conditions, with the interval of serial assay being reduced to 3 hours. The aim of this review is to
complement the advantages, to emphasize on proper interpretation of positive results, to appraise the challenges faced with the available cardiac
troponin assays and need for further research to overcome them and build up the most ideal cardiac marker for diagnosing the
myocardial infarction.