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Novel percutaneous interventional therapies in heart failure with preserved ejection fraction: an integrative review First-in-man evaluation of intravascular optical frequency domain imaging (OFDI) of Terumo: a comparison with intravascular ultrasound and quantitative coronary angiography Consensus from the 5th European Bifurcation Club meeting A Randomized Study of Distal Filter Protection Versus Conventional Treatment During Percutaneous Coronary Intervention in Patients With Attenuated Plaque Identified by Intravascular Ultrasound Clopidogrel Pharmacogenetics: State-of-the-Art Review and the TAILOR-PCI Study Economic and Quality-of-Life Outcomes of Natriuretic Peptide–Guided Therapy for Heart Failure SGLT-2 Inhibitors and Cardiovascular Risk: An Analysis of CVD-REAL Fluid Volume Overload and Congestion in Heart Failure: Time to Reconsider Pathophysiology and How Volume Is Assessed Nuclear Imaging of the Cardiac Sympathetic Nervous System: A Disease-Specific Interpretation in Heart Failure The Future of Biomarker-Guided Therapy for Heart Failure After the Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) Study

Expert Opinion2018;3(2):112-113.

JOURNAL:JAMA Cardiol. Article Link

The Wait for High-Sensitivity Troponin Is Over—Proceed Cautiously

Korley FK Keywords: Acute Coronary Syndromes; Cardiology Emergency Medicine; Research Methods; Statistics; Ischemic Heart Disease

ABSTRACT


Since high-sensitivity troponin (hsTn) assays became available for clinical use in Europe in 2010, clinicians in the United States have been waiting eagerly for US Food and Drug Administration (FDA) approval. It is finally here. High-sensitivity troponin assays hold promise for earlier diagnosis of myocardial infarction (MI), a decrease in the time required to rule out MI, a reduction in sex bias in the diagnosis of MI, and an improvement in the diagnosis of cardiac injury in noncardiac conditions, among other effects. It may also result in a redefinition of the concept of unstable angina. In this issue of JAMA Cardiology, Peacock et al report findings from the first study of the diagnostic accuracy of the FDA-approved high-sensitivity troponin T (hsTnT) assay in patients in US emergency departments who were evaluated for suspected acute coronary syndrome (ACS). The authors deserve commendation for rigorously conducting a timely study that provides crucial data that will inform strategies for implementing hsTn in the United States. This rigorously implemented multicenter observational study generated important findings that may excite enthusiasts while making skeptics cautious.