Turkish Society of Cardiology consensus report on the rational use of cardiac troponins in daily practice

Cardiac troponins (cTn T and I) are protein molecules that are part of the contractile apparatus of the cardiac muscle. Increase in these biomarkers represents injury of myocardial cells without giving any evidence for the underlying mechanism (1, 2). In the latest (fourth) Expert Consensus Document of Universal Definition of Myocardial Infarction (2), it has been emphasized that the clinical definition of myocardial infarction (MI, types 1, 2, and 3) refers to the presence of acute myocardial injury detected by typical rise and/or fall of cTn in the setting of acute myocardial ischemia evidenced by at least one of the following findings: • Ischemic symptoms • New alterations in electrocardiography (ECG) related with ischemia • Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality • Demonstration of coronary thrombus Cardiac troponins are also the mainstay for diagnostic algorithms of acute chest pain as explained in the latest European Society of Cardiology (ESC) Guideline to manage acute coronary syndromes (ACS) in patients presenting without persistent STsegment elevation (3).