Patients admitted with suspicion of an acute coronary syndrome still constitute a diagnostic, prognostic and therapeutic challenge. In the vast majority of these patients the diagnosis is dependent on the results of measurements of cardiac markers. The troponins have a higher diagnostic sensitivity and specificity for detection of myocardial damage than previous markers and have also been proved to be valuable for early risk stratification. There is emerging evidence that these new cardiac markers might be used for selection of treatment in various forms of acute coronary syndromes.