Cardiac troponin is the preferred marker of myocardial cell necrosis.1 Recently, highly sensitive assays have become available that allow the detection of very low con-centrations of circulating cardiac troponin in healthy indi-viduals.2–5 Increasing troponin concentrations, even those well within the normal reference interval, are positively associated with adverse cardiovascular outcome in primary prevention populations. These adverse outcomes include myocardial infarction (MI), congestive heart failure, and cardiovascular death.2–6 Assays for B-type natriuretic peptide (BNP) are widely used for diagnosis and risk stratification of patients presenting with suspected heart failure.7,8 BNPs also have strong associations with adverse cardiovascu-lar outcome in a variety of primary prevention and general populations.9–12 Clinical Perspective on p 186

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