4.6 Article

Evidence on clinical relevance of cardiovascular risk evaluation in the general population using cardio-specific biomarkers

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WALTER DE GRUYTER GMBH
DOI: 10.1515/cclm-2020-0310

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cardiac natriuretic peptides; cardiac troponins; cardiovascular risk; high-sensitivity immunoassay; quality specification; reference population

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Recent studies have shown that high-sensitivity cTn methods can accurately measure cardiac troponin concentrations and are associated with cardiovascular event risk. Early treatment of individuals at higher cardiovascular risk may slow down myocardial remodelling and heart failure progression.
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 of heart 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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