A low-cost blood test that measures a protein called troponin could dramatically improve the ability to predict heart attacks and strokes years before they happen, according to new research from the London School of Hygiene & Tropical Medicine (LSHTM).
The study, published in the Journal of the American College of Cardiology, suggests that routinely using this test alongside standard health checks could identify people at higher risk and help doctors take earlier preventive steps.
Troponin is a protein found in heart muscle. It’s already used in hospitals to diagnose heart attacks, because it’s released into the blood when the heart is damaged.
But researchers found that even small, “normal” amounts of troponin in the blood could be a warning sign of silent, ongoing heart damage. This hidden damage may signal a future risk of cardiovascular disease—even in people who seem otherwise healthy.
The study examined health records from over 62,000 people in Europe, North America, and Australia. All participants had their troponin levels measured, along with common risk factors like age, blood pressure, cholesterol, smoking, and diabetes. The researchers then tracked whether participants experienced a heart attack or stroke over the next 10 years.
Currently, doctors use risk calculators to estimate a person’s chance of having a heart attack or stroke within 10 years. These calculators often rely on cholesterol levels from a blood test, along with other personal health data.
But the researchers discovered that adding troponin test results made the predictions far more accurate—up to four times more so than relying on cholesterol alone.
This improvement was especially useful for people in the “intermediate risk” category. These are people whose 10-year risk of heart attack or stroke is between 2.5% and 15%.
Right now, there’s uncertainty about whether these individuals should start taking preventive medications like statins, because their risk isn’t considered high enough. The study found that adding troponin results could help doctors reclassify some of these patients to high risk, giving them a clearer reason to begin preventive treatment.
In fact, modeling showed that giving the troponin test to intermediate-risk individuals could prevent one heart attack or stroke for every 500 people tested. The test costs just £5—similar to a cholesterol test—making it an affordable tool for national health services like the NHS.
Professor Anoop Shah, who led the study, said the test gives a clearer picture of heart health. “Even when troponin levels are within the normal range, they can indicate silent heart damage. This offers an extra layer of information that helps us better predict who is truly at risk,” he explained.
Dr. Spencer Keene from the University of Cambridge added that the test could help reduce the uncertainty doctors face when deciding whether preventive treatment is needed. He also noted that the test may be particularly helpful in older adults and people with diabetes—groups that often fall into the grey area of intermediate risk.
Still, the researchers emphasized that more studies are needed to understand how troponin testing could work in real-world settings, especially in lower-income countries. So far, the data mostly comes from high-income populations, and results may not be the same worldwide.
Professor Bryan Williams from the British Heart Foundation said this research points to an exciting new tool in the fight against heart disease.
“With around 100,000 hospital admissions for heart attacks each year in the UK, better risk prediction is urgently needed,” he said. “Adding troponin testing could help doctors identify more people who need help—and help prevent future heart attacks and strokes.”
In summary, this study suggests that a simple, low-cost blood test could become a powerful new way to prevent some of the deadliest health conditions. By spotting silent heart damage years in advance, doctors could act earlier to protect people’s health, reduce emergency hospital visits, and potentially save thousands of lives.
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The research findings can be found in Journal of the American College of Cardiology.
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