Background

Acute Coronary Syndrome (ACS) remains a major cause of cardiovascular morbidity and mortality worldwide. Rapid diagnosis and timely coronary intervention are critical for improving clinical outcomes. High-sensitivity cardiac troponin (hs-cTn) assays have revolutionized the diagnosis of myocardial injury by enabling earlier and more accurate detection of myocardial necrosis compared with conventional troponin assays.

Objective

This study evaluates the role of high-sensitivity troponin in guiding early coronary intervention among patients presenting with suspected ACS, emphasizing diagnostic performance, risk stratification, timing of revascularization, and long-term cardiovascular outcomes.

Methods

A systematic review of randomized clinical trials, cohort studies, registry analyses, and international guideline recommendations published between 2010 and 2025 was conducted. Studies evaluating hs-cTn-guided management strategies and coronary intervention outcomes were included.

Results

High-sensitivity troponin significantly improves early diagnosis of myocardial infarction, enhances risk stratification, and facilitates timely coronary angiography and revascularization. Elevated hs-cTn levels correlate strongly with plaque instability, coronary lesion complexity, and adverse cardiovascular outcomes. Early invasive management guided by hs-cTn demonstrates reductions in recurrent myocardial infarction, heart failure, and major adverse cardiovascular events (MACE).

Conclusion

High-sensitivity troponin has become an indispensable biomarker in contemporary cardiology. Its integration into diagnostic algorithms and invasive management pathways enables earlier identification of high-risk patients and supports precision-guided coronary intervention strategies.