Clinical Impact of High Sensitive Troponin I Assay

Cardiac Troponin is drawing increasing attention from cardiologists, clinicians, researchers, and authorities in Japan, as illustrated by the revision of the PCI reimbursement plan in April 2014 and that of the JCS STEMI Guidelines in December 2013. In the revised PCI reimbursement plan, it is stated that 10,000 points will be added for the performance of PCI when Troponin is positive together with myocardial ischemic observations. In the revised STEMI Guidelines, a description was added stating that high sensitive Troponiri assays are superior to all other cardiac markers, including myoglobin, CK-MB, H-FABP, and conventional Troponin assays. With high sensitive Troponin assays, including hsTnI recently developed by Abbott that can measure 96% of the normal population, increasing numbers of researchers are actively involved in research to elucidate whether high sensitive Troponin assays are useful not only for the diagnosis of ACS (acute coronary syndromes), but also for the prognosis of chronic heart diseases such as heart failure, high blood pressure, diabetes, or metabolic syndrome. In this review, we describe high sensitive Troponin assays from various viewpoints.