Photo caption: Hamilton Health Sciences clinical biochemist Pete Kavsak is the research lead for the Hamilton Regional Laboratory Medicine Program (HRLMP), and also conducts award-winning research. Kavsak and his team have spent the past 20-plus years working to improve lab tests used to detect heart injury.
When Dr. Pete Kavsak’s father-in-law went to his local emergency department (ED) with chest pain back in 2004, his care included a lab test to check for a protein called troponin in his blood. Troponin lives inside heart muscle cells, helping the heart contract and pump blood. If troponin is detected in the bloodstream, it’s a sign of heart damage.
The troponin blood test came back clear and the ED doctor, finding no other signs of heart damage, sent his father-in-law home where he died suddenly later that night. The tragedy set Kavsak, now a Hamilton Health Sciences (HHS) clinical biochemist, on a career-long mission to save lives by improving this blood test’s accuracy through better detection of troponin.
“Shortly after my father-in-law passed away, I spoke to his ED doctor, and I remember two key takeaways,” recalls Kavsak.
“First, my father-in-law didn’t tell the ED doctor that he had a heart condition. And second, although the doctor correctly interpreted the blood test results, the test back then wasn’t sensitive enough to detect lower levels of troponin that could signal early signs of heart damage. It was the best test we had at that time, but it wasn’t good enough to save my father-in-law and others like him.”
Lifesaving, Award-Winning Research
Kavsak and his team have spent the past 20-plus years working to improve lab tests used to detect heart injury. They’re supported by the Canadian Institutes of Health Research, and by partners including industry and HHS physicians, researchers and patients who volunteer for studies.
Kavsak and his team demonstrated the importance of low levels of cardiac troponin and then worked with industry to develop better tests, such as high-sensitivity cardiac troponin testing, which is now the gold standard for heart injury and heart attacks.
Kavsak works as a biochemist and research lead for the Hamilton Regional Laboratory Medicine Program (HRLMP), and also conducts research. The program is a partnership between HHS and St. Joseph’s Healthcare Hamilton (SJHH). It’s one of the largest such lab service programs in the country, with 30 labs across both hospital networks and over 700 team members. The HRLMP’s work supports nearly every patient at HHS and SJHH, as well as other patients regionally, provincially, and beyond.
This past May, Kavsak received the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) 2025 Distinguished Award for contributions to cardiovascular diagnostics. It’s a major honour recognizing his global influence, with a focus on improving troponin testing. He is also a professor in pathology and molecular medicine at McMaster University.
Most recently, at October’s HHS Research and Innovation Awards event, Kavsak received an HHS Foundation 2025 Breakthrough Award for leading-edge research, for his project Improving Cardiac Troponin Testing Accuracy in Breast Cancer Patients treated with Herceptin. He collaborated with clinicians and scientists affiliated with the Escarpment Cancer Research Institute (ECRI), where he is also an associate scientist.
Troponin 101
In a healthy heart, troponin stays inside heart muscle cells, where it helps the muscle contract and pump blood. But if the heart muscle is injured during, for example, a heart attack, blood flow is blocked and parts of the heart don’t get enough oxygen. This, in turn, causes the muscle cells to start breaking down or dying, and as this happens the troponin inside them leaks into the bloodstream. That’s why a blood test is used to measure troponin levels. If the test shows troponin in the bloodstream, it’s a strong sign that some of the heart muscle has been injured.
Two decades ago, when Kavsak’s father-in-law died, the test wasn’t sensitive enough to detect very low levels of troponin in patients with early signs of heart injury.
“Over the years we’ve been able to develop testing that’s tenfold more sensitive and tenfold more precise,” says Kavsak, adding, “We’re measuring the same protein but we’re now able to do it much better. Now, tiny increases can be detected using high-sensitivity cardiac troponin tests, which help doctors catch heart injury earlier and more accurately.”
Today, when someone arrives at an ED with chest pain or shortness of breath, blood testing plays a major role in diagnosing heart damage and deciding on next steps for care. This testing also plays a role in reducing delays and unnecessary hospital stays. Kavsak, with his team and collaborators, have had a major impact with several hundred publications of studies in this area.
Kavsak’s research includes creating and improving algorithms to help doctors make decisions about care more accurately and safely. His research has also found that combining troponin with other blood tests such as kidney function and glucose tests, improves accuracy of risk assessment. This helps predict not only whether someone is having or will have a heart attack, but also their short-term risk for another serious cardiovascular outcome.
He also helped propose and validate better rules and criteria for interpreting changes in troponin levels and establishing quality standards.
Troponin testing isn’t limited to patients with suspected heart attacks. It can also be used to detect heart injury in other at-risk populations, such as those recovering from surgery, undergoing cancer treatments that are potentially toxic to the heart, or even outside the hospital setting.
“Our goal is to ensure no patient in danger of a cardiac issue is missed,” says Kavsak, adding, “None of these advancements in testing would have been possible without the support of HHS and its researchers, clinicians and patients.”