ReviewsThe combined measurement of high-sensitivity cardiac troponins and natriuretic peptides: a useful tool for clinicians?Perrone, Marco A.a; Zaninotto, Martinac,d; Masotti, Silviae; Musetti, Veronicae; Padoan, Andreac,d; Prontera, Concettae; Plebani, Marioc,d; Passino, Claudioe; Romeo, Francescoa; Bernardini, Sergiob; Clerico, AldoeAuthor Information aDivision of Cardiology, University of Rome Tor Vergata bDivision of Clinical Biochemistry and Clinical Molecular Biology, University of Rome Tor Vergata, Rome cDepartment of Medicine, University of Padova dDepartment of Laboratory Medicine, University Hospital of Padova, Padova eLaboratory of Cardiovascular Endocrinology and Cell Biology, CNR-Regione Toscana, Foundation, G. Monasterio and Scuola Superiore Sant’Anna, Pisa, Italy Correspondence to Marco A. Perrone, MD, Division of Cardiology, University of Rome Tor Vergata, Rome, Italy E-mail: [email protected] Received 17 December, 2019 Revised 25 April, 2020 Accepted 1 May, 2020 Journal of Cardiovascular Medicine: December 2020 - Volume 21 - Issue 12 - p 953-963 doi: 10.2459/JCM.0000000000001022 Buy Metrics Abstract An enormous amount of experimental and clinical evidence has clearly shown that the measurement of cardio-specific biomarkers is able to significantly and independently improve the diagnostic accuracy and risk stratification in cardiovascular diseases. Furthermore, many recent studies have reported that the measurement of cardio-specific biomarkers has a positive impact also on the management and outcome of patients with cardiovascular diseases. Considering the significant and independent information associated with cardio-specific biomarkers, several studies have recently reported that the combined dosage of natriuretic peptides and cardiac troponins may be convenient not only for the diagnosis, prognosis, and treatment of heart disease, but also for general screening of the population for individuals with high cardiovascular risk. Due to the higher cost of cardio-specific biomarkers compared with other laboratory tests, the clinical adequacy of the combined measurement of natriuretic peptides and cardiac troponins must be carefully evaluated. Consequently, an increase in the clinical use of a laboratory test should be based not only on the favorable pathophysiological characteristics of a biomarker, but also on the high performance of the methods used for biomarker dosing. The purpose of this review is to discuss the clinical relevance and the possible cost efficiency of the combined dosage of natriuretic peptides and cardiac troponins in some clinical conditions, in particular those most frequently observed in patients with critical illnesses admitted to the emergency room. © 2020 Italian Federation of Cardiology - I.F.C. All rights reserved.