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Published on: September 26, 2018
Evidence on clinical relevance of cardiovascular risk evaluation in the general population using cardio-specific
Aldo Clerico1, Martina Zaninotto2,3, Claudio Passino1
1Scuola Superiore Sant'Anna, Fondazione CNR - Regione Toscana G. Monasterio, Pisa, Italy.
Insights
High-sensitivity cardiac troponin assays accurately measure cardiac troponin I (cTnI) and T (cTnT) levels, identifying cardiovascular event risk even within reference intervals. Early treatment based on these biomarkers can slow heart failure progression.
Area of Science:
- Cardiology
- Biomarker Analysis
- Clinical Diagnostics
Background:
- Recent advancements in immunoassay technology enable precise measurement of cardiac troponin I (cTnI) and T (cTnT).
- Elevated cTnI and cTnT levels, even within reference ranges, correlate with increased risk of major cardiovascular events.
- High-sensitivity troponin (hs-cTn) assays offer new insights into myocardial remodeling and heart failure risk stratification.
Purpose of the Study:
- To explore the utility of hs-cTn assays in identifying individuals at high risk for heart failure (HF) progression.
- To evaluate the potential of early intervention strategies guided by hs-cTn measurements.
- To advocate for clinical trials assessing the cost-effectiveness of general population screening using hs-cTn.
Main Methods:
- Utilized high-sensitivity immunoassays for accurate cTnI and cTnT quantification.
- Analyzed existing study data demonstrating associations between troponin levels and cardiovascular event risk.
- Reviewed literature on myocardial remodeling and heart failure progression.
Main Results:
- hs-cTn methods allow for accurate cTnI and cTnT measurement in reference populations.
- Cardiac troponin concentrations, even within reference intervals, are linked to cardiovascular event risk.
- hs-cTn assays can monitor myocardial remodeling and identify high-risk patients for heart failure.
Conclusions:
- Early detection and treatment of high-risk individuals using hs-cTn can potentially revert myocardial remodeling and slow HF progression.
- Further clinical trials are needed to establish the efficacy, efficiency, and cost-benefit of general population screening with hs-cTn.
- hs-cTn assays represent a promising tool for personalized cardiovascular risk assessment and management.
Abstract:
In recent years, the formulation of some immunoassays with high-sensitivity analytical performance allowed the accurate measurement of cardiac troponin I (cTnI) and T (cTnT) levels in reference subjects. Several studies have demonstrated the association between the risk of major cardiovascular events and cardiac troponin concentrations even for biomarker values within the reference intervals. High-sensitivity cTnI and cTnT methods (hs-cTn) enable to monitor myocardial renewal and remodelling, and to promptly identify patients at highest risk ofheart failure. An early and effective treatment of individuals at higher cardiovascular risk may revert the initial myocardial remodelling and slow down heart failure progression. Specific clinical trials should be carried out to demonstrate the efficacy and efficiency of the general population screening by means of cost-benefit analysis, in order to better identify individuals at higher risk for heart failure (HF) progression with hs-cTn methods.
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