Abstract

THE ROLE OF TROPONIN TESTING IN EARLY DIAGNOSIS OF ACUTE CORONARY SYNDROMES

Fahdah Mehsan Alotaibi* and Abdullah Ibrahim Al Eissa

ABSTRACT

Background: Acute coronary syndromes (ACS) represent a significant cause of morbidity and mortality worldwide, necessitating prompt and accurate diagnosis to improve clinical outcomes. Traditional diagnostic methods, including electrocardiography (ECG) and clinical symptom evaluation, often lack sufficient sensitivity and specificity, particularly in atypical presentations. Cardiac troponins, specifically Troponin I and Troponin T, have emerged as critical biomarkers for myocardial injury, transforming the diagnostic approach to ACS. The advent of high-sensitivity troponin assays has further enhanced diagnostic precision, enabling earlier detection of myocardial injury and stratification of patient risk. Aim: This paper aims to evaluate the role of troponin testing in the early diagnosis of ACS, emphasizing thediagnostic superiority of high-sensitivity troponin assays. Additionally, it explores the clinical implications of troponin testing in risk stratification, therapeutic decision-making, and its integration into emergency medicine protocols. Methods: The study undertakes a comprehensive review of recent peer-reviewed literature, clinical trials, and meta-analyses. Diagnostic performance metrics, including sensitivity, specificity, and predictive value, are analyzed for conventional and high-sensitivity troponin assays. Data from clinical case studies highlight the utility of troponin testing in diverse emergency department settings. Results: High-sensitivity troponin assays demonstrated improved diagnostic accuracy for ACS, particularly in early detection and differentiation from non-ischemic conditions. Troponin testing significantly enhanced risk stratification and informed timely therapeutic interventions, reducing hospital admissions and improving patient outcomes. Conclusion: Troponin testing, particularly high-sensitivity assays, is a cornerstone in the early diagnosis of ACS. While challenges such as false positives and assay variability persist, advancements in technology and integration into clinical protocols underscore its transformative role in emergency medicine.

Keywords: Troponin, Acute Coronary Syndrome, High-Sensitivity Troponin, Early Diagnosis, Emergency Medicine, Biomarkers, Risk Stratification.