MEASUREMENT OF CARDIAC TROPONINS: PRINCIPLES, DIAGNOSTIC VALUE, AND CLINICAL APPLICATIONS

Cardiac troponins (cTn), specifically troponin I (cTnI) and troponin T (cTnT), represent the most sensitive and specific biomarkers for myocardial injury. Their measurement has transformed the diagnostic landscape of acute coronary syndromes (ACS), enabling earlier recognition of myocardial infarction (MI), improved risk stratification, and better prognostic modeling. Modern high-sensitivity cardiac troponin (hs-cTn) assays can detect extremely low concentrations, allowing identification of myocardial injury even in subclinical states.

This article provides an evidence-based synthesis of the biological basis of troponin release, analytical principles of troponin measurement, diagnostic thresholds, clinical algorithms, and limitations. By integrating data from clinical trials, pathology research, analytical validation studies, and international cardiology guidelines, this review aims to clarify how troponin measurement informs diagnosis and management in diverse clinical settings.