The BHF Butler Senior Clinical Research Fellowship. High-sensitivity cardiac troponin and coronary heart disease

A simple blood test could determine whether someone with chest pain needs urgent treatment or can be safely sent home, replacing the current imprecise assessment methods. Current strategies for diagnosing coronary heart disease are unreliable, leading to two equally harmful outcomes: some patients receive unnecessary lifelong treatments, while others at high risk of heart attack or death are missed entirely. This imprecision stems from the lack of a reliable biological marker that can accurately gauge heart health in stable patients. This research proposes to use high-sensitivity cardiac troponin testing—already standard for diagnosing heart attacks—as a continuous "barometer" of cardiac health in people with stable coronary heart disease. The researcher will test whether troponin concentrations can predict future cardiac events and whether changes in those levels track with patient outcomes. If successful, this approach would transform how doctors diagnose, risk-stratify, and manage millions of patients with stable coronary heart disease, turning a test currently reserved for emergencies into a routine tool for long-term care. The result would be fewer unnecessary treatments, fewer missed high-risk patients, and a more precise, personalised approach to heart disease management.