Troponin remains the cornerstone biomarker for diagnosing myocardial injury, guiding clinical decision-making in acute coronary syndromes and a wide spectrum of cardiovascular conditions. With the evolution of high-sensitivity assays, clinicians increasingly seek updated perspectives on Troponin interpretation when attending diagnostics and emergency-care tracks at a cardiology conference. Because troponin elevation now reflects a broad range of cardiac and systemic processes beyond myocardial infarction, this session provides a nuanced exploration of advanced cardiac biomarker interpretation in modern practice.

The session begins by reviewing the molecular structure of cardiac troponins I and T, their release kinetics following myocardial injury and the biological mechanisms underlying their elevation. Participants learn how ischemic and non-ischemic factors—including myocarditis, tachyarrhythmias, heart failure, renal dysfunction, pulmonary embolism and sepsis—produce variable troponin patterns. Differences between conventional and high-sensitivity assays are explored, emphasising their detection thresholds, analytical precision and clinical implications.

Diagnostic algorithms form a core focus. Attendees examine 0/1-hour and 0/2-hour accelerated pathways, delta-change criteria and strategies for differentiating chronic elevations from acute dynamic changes. Special attention is given to interpreting low-level elevations, age- and sex-specific cutoffs and challenges associated with false positives due to analytical interference, heterophile antibodies and skeletal muscle cross-reactivity.

Clinical case discussions help illustrate how troponin should be integrated with symptoms, ECG findings, imaging and clinical judgement. Participants review scenarios involving acute myocardial infarction, type 2 myocardial injury, post-procedural elevations, critical illness and complex presentations requiring careful contextualisation. The session also highlights troponin’s prognostic role across heart failure, stable CAD, arrhythmias and cardiovascular risk prediction.

Operational considerations include laboratory workflow, point-of-care testing, assay standardisation and communication between cardiology and clinical laboratory teams. Participants explore how troponin results influence early disposition decisions, resource utilisation and hospital throughput.

Future directions include ultra-high-sensitivity assays, multi-marker panels, AI-assisted interpretation models and molecular profiling that differentiates ischemic injury from inflammatory and metabolic mechanisms. By mastering troponin interpretation, participants enhance diagnostic accuracy, reduce unnecessary testing and improve patient stratification.