“It Was the Best of Times, It was The Worst of Times”: Cardiovascular Disease and Troponins

There have been significant changes in the diagnosis and definition of acute myocardial infarction over the years. From its first description and definition over 150 years ago to the high sensitivity cardiac troponin assays of today, we have come a long way in the diagnosis, management, and treatment of those with cardiovascular disease. With the recent Food and Drug Administration’s (FDA) clearance of a fifth generation high-sensitivity cardiac troponin assay, a new history in diagnosing, treatment and managing those with heart disease is just beginning. The three articles associated with this focus series describe advances in diagnosis and definition of acute myocardial infarction (AMI) with a specific focus on troponins. The first article presents an in-depth description into the structure and function of troponin in health and disease. The second article presents a description of myocardial infarction (MI), how the diagnosis and definition of MI has changed over the years and ends with a description of the high sensitive troponin assays. The third article presents clinical implications of the new high sensitivity troponin assays.