High-sensitivity troponin testing is enabling earlier detection of myocardial injury and supporting faster diagnostic pathways for patients with suspected heart attacks.
By Dr. Lindy Carlstrom, Medical Affairs Manager at QuidelOrtho
Heart disease is the leading cause of death in the United States for men and women across most racial and ethnic groups, underscoring the condition as a serious national public health crisis that causes roughly one in every three deaths. That’s one life every 34 seconds.
Anyone can develop heart disease, but some people are at a higher risk. Factors include high blood pressure, high blood cholesterol, and smoking. Other medical conditions and lifestyle choices can put individuals at a higher risk, including diabetes, obesity, an unhealthy diet, or excessive alcohol use.1 Early intervention and diagnosis of myocardial injury or myocardial infarction (heart attack) can mean the difference between life and death because, in cardiac care, every minute matters.
Why High-Sensitivity Troponin Matters in Acute Cardiac Care
There are about 2,205 heart attacks every day in the United States.1 During a cardiac event, a rise or fall in the blood level of a protein called cardiac troponin may occur, which is where high-sensitivity troponin testing can play a critical role in patient outcomes.2
High-sensitivity troponin testing allows clinicians to detect very low levels of cardiac troponin with a high degree of precision. High precision is essential because even small increases in troponin can indicate myocardial injury. For proper diagnosis, clinicians rely on serial testing, the practice of ordering multiple high-sensitivity troponin tests, which allows them to observe changes in troponin levels over time rather than relying on a single measurement.
Due to the importance of identifying changes in troponin levels, it is important for a troponin test to have good precision so that clinicians can be confident that the change between serial tests is due to changes in the patient and not normal variation from the assay.
Precision can be explained as follows. When a sample is measured multiple times, a test with great precision produces results that are very close to each other. For example, producing measurements like 10.0, 9.9, and 10.1 indicates good precision because the results are within ±1% of each other. Bad precision would be measurements like 10, 8, and 12, as the results are within ±20% of each other.3
High analytical precision at low and very low troponin levels ensures that small, yet clinically meaningful changes between serial samples are caused by physiological changes in the patient and not due to assay variability. This reliable low-end precision is essential for accurate diagnosis, risk stratification, and serial testing. Good assay precision means the test can detect rising or falling patterns, thereby strengthening diagnostic accuracy and helping differentiate acute injury from chronic elevations.
By identifying these changes earlier, clinicians can make faster, more informed decisions when evaluating patients with suspected myocardial injury.3
Transforming Workflows and Challenges for Clinicians to Consider
High-sensitivity troponin testing supports accelerated diagnostic pathways, allowing clinicians to evaluate patients over shorter periods of time. While contemporary troponin serial testing could take up to six hours, high-sensitivity troponin testing can be completed in zero to two hours. This faster workflow can reduce length of stay in emergency departments, improving patient flow and helping to prioritize care for those who need urgent intervention while safely ruling out cardiac events in those who do not need intervention.3
Clinical guidelines increasingly recommend high-sensitivity troponin testing because of its diagnostic accuracy and clinical utility. Alignment with evidence-based guidelines helps ensure consistency of care, supports consistency between diagnostic pathways, and reinforces clinicians’ confidence in test results.3
However, no test is used in isolation; clinical context is important to consider. Because high-sensitivity assays detect very small troponin concentrations, not every elevation reflects an acute heart attack. Other conditions, which damage the heart, such as heart failure, renal disease, or sepsis, can also cause troponin elevations, reinforcing the importance of combining laboratory data with clinical assessment. 3
The Impact on Patient Outcomes
One of the key advantages of high-sensitivity troponin testing is its strong negative predictive value. A low or unchanged troponin level over time can provide clinicians with confidence that a heart attack is unlikely, help avoid unnecessary hospital admissions, and allow low-risk patients to be safely discharged sooner.3
Earlier diagnosis allows for faster initiation of appropriate treatment, whether that means urgent intervention for a heart attack or appropriate care pathways for non-cardiac causes. Timely diagnosis and intervention are associated with reduced mortality and improved long-term outcomes for patients with acute coronary syndromes.3
Looking Ahead
High-sensitivity troponin testing will continue to be foundational in cardiac diagnostics, supporting faster decision-making, improved patient flow, and more personalized risk assessment. New disease areas in which researchers are endeavoring to apply high-sensitivity troponin include cardio-oncology, noncardiac surgery, and screening of the general population for cardiovascular risk prediction. Although, all of these need further evidence for the right treatment that improves patient outcomes before specific recommendations can be provided.4
Generally, a physician’s responsibility is not only to identify the risk of disease but also to advise on how to manage disease risk.4 High-sensitivity troponin testing will continue to be foundational in cardiac diagnostics, supporting faster decision-making, improved patient flow, and more patient-specific risk assessment. As healthcare systems focus increasingly on early intervention and preventive care, high-sensitivity troponin will remain a key tool in delivering timely, high-quality cardiovascular care.3
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References
- Centers for Disease Control and Prevention. Heart disease facts & statistics. Accessed 2026 Feb 5. Available at https://www.cdc.gov/heart-disease/data-research/facts-stats/index.html
- Cleveland Clinic. Heart attack (myocardial infarction). Accessed 2026 Feb 5. Available at https://my.clevelandclinic.org/health/diseases/16818-heart-attack-myocardial-infarction
- QuidelOrtho. Every minute matters: the power of high-sensitivity troponin. Accessed 2026 Feb 17. Available at https://www.quidelortho.com/us/en/resources/podcasts/Every-minute-matters–The-power-of-high-sensitivity-troponin
- Krychtiuk KA, Newby LK. High-sensitivity cardiac troponin assays: ready for prime time!. Annu Rev Med. 2024;75:459-74. Available at https://doi.org/10.1146/annurev-med-051022-113931
