Troponin: Messenger or Actor?

Cardiac troponin (cTn) is a biomarker of myocardial damage. New generations of high-sensitivity assays find circulating cTn in virtually all subjects. Multiple studies in various populations and patient groups have found higher levels of cTn to be predictive of future heart failure. The author proposes that initial myocardial damage from various mechanisms may lead to anti-cTn antibodies that participate in ongoing myocardial damage that eventually results in heart failure.