hscTnT

High-sensitivity cardiac troponin T (hs-cTnT) is a laboratory biomarker assay that measures troponin T with enhanced sensitivity and precision. The hs-cTnT test can detect very low concentrations of-troponin T in most people, enabling earlier identification of myocardial injury compared with earlier troponin assays. The 99th percentile upper reference limit commonly used for hs-cTnT is about 14 ng/L, though exact values can vary by assay lot and manufacturer.

In clinical practice, hs-cTnT is a key tool in the evaluation of patients with suspected acute coronary syndrome (ACS). It is typically measured on presentation and repeated after 1–3 hours to identify dynamic changes consistent with myocardial injury. A rising or falling pattern supports ACs-related myocardial injury and can help rule in or rule out myocardial infarction when combined with clinical assessment and ECG findings. Because hs-cTnT is highly sensitive, it can facilitate faster risk stratification and, for some patients, earlier safe discharge from emergency departments.

Interpretation of hs-cTnT results requires clinical context. Values above the 99th percentile indicate myocardial injury but do not by themselves specify the cause; troponin can be elevated in nonischemic conditions such as myocarditis, heart failure, pulmonary embolism, renal failure, sepsis, or chronic myocardial injury. Baseline elevations or small persistent elevations are common in chronic kidney disease and other chronic illnesses, and age and comorbidity can influence levels. Therefore, hs-cTnT results should be integrated with symptoms, ECG, imaging, and serial measurements.

Limitations include potential nonischemic true positives, preanalytical and analytical variability, and assay-specific characteristics.