High-Sensitivity Troponin as a Biomarker in Heart Rhythm Disease

• Type of Material: Article
• Authors: Cian P. McCarthy, Massachusetts General Hospital; Omair Yousuf, Johns Hopkins University; Alvaro Alonso, Emory University; Elizabeth Selvin, Johns Hopkins University; Hugh Calkins, Johns Hopkins University; John W. McEvoy, Johns Hopkins University
• Language: English
• Date: 2017-05-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.amjcard.2017.01.032
• Title of Journal or Parent Work: American Journal of Cardiology
• ISSN: 0002-9149
• Volume: 119
• Issue: 9
• Start Page: 1407
• End Page: 1413
• Grant/Funding Information: Dr. McEvoy is supported by the American Heart Association grant 17MCPRP33400031.; Alonso is supported by the American Heart Association grant 16EIA26410001.
• Keywords: POSTOPERATIVE ATRIAL-FIBRILLATION; RISK STRATIFICATION; T LEVELS; SUDDEN CARDIAC DEATH; Cardiovascular System & Cardiology; SERIAL MEASURES; PREDICTING STROKE; OLDER-ADULTS; Cardiac & Cardiovascular Systems; HYPERTROPHIC CARDIOMYOPATHY; Life Sciences & Biomedicine; Science & Technology; ATHEROSCLEROSIS RISK; ASSAY
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

Biomarkers are important prognostic tools in various cardiovascular conditions, including coronary artery disease and heart failure. Although their utility in cardiac electrophysiology (EP) is less established, biomarkers may guide EP clinical practice by identifying patients at risk for developing arrhythmias and their complications, in addition to augmenting therapeutic decisions by tar geting appropriate pharmacologic and interventional therapies to patients who may benefit most. In this review, we focus on the prognostic role of high-sensitivity cardiac troponin (hs-cTn) assays—which detect subclinical cardiac myocyte damage—in cardiac arrhythmias and their sequelae. We review the current literature on hs-cTn and its impact on various arrhythmia disease states and also provide suggestions for future research in this field. In conclusion, although the utility of hs-cTn assays remains at an investigational stage in cardiac EP, studies to date have suggested value as a prognostic biomarker in atrial fibrillation and as a screening marker for patients at high risk of sudden cardiac death (both in the general population and among those with hypertrophic cardiomyopathy).