High‐Sensitivity Troponin Assays: Evidence, Indications, and Reasonable Use

نویسندگان

  • Matthew W. Sherwood
  • L. Kristin Newby
چکیده

W ith advances in technology, a new era in troponin assays is approaching. Previous-generation troponin assays have been used as diagnostic and prognostic markers in acute coronary syndrome patients and for risk stratification to guide triage decisions and aid in treatment selection. New, high-sensitivity troponin assays represent an important advance with added sensitivity for cardiac myocyte necrosis, but there remains a need for judicious interpretation with these tests. These new troponin assays could have several distinct roles in clinical practice: (1) facilitation of earlier diagnosis and rule out of myocardial infarction (MI); (2) risk stratification in acute cardiac conditions and prognostic information in stable disease states; and (3) therapeutic monitoring and drug toxicity evaluation. However, because they are not specific for the etiology of cardiac cell death, the clinician has an increasing responsibility to interpret each test in clinical context. When commercially available in the United States (US), these high-sensitivity analyses are expected to offer both advantages and disadvantages to practicing clinicians and to enhance current roles of the troponin assay as well as to open doors to new uses for troponin testing. However, they will also create new challenges in clinical applications, epidemiology, and research. The aim of this review is to discuss the potential clinical and research roles of high-sensitivity cardiac troponin assays and the challenges they may create. Assay Development

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

High sensitivity cardiac troponin testing.

Bösner and colleagues have presented evidence for a simple rule for ruling out coronary artery disease in the primary care setting. It is noteworthy that no laboratory measurements have been included in their model, with reference to their introductory statement that “ ... electrocardiography and cardiac troponin test are of limited value in primary care... ” This point deserves some discussion...

متن کامل

Consensus statement on the use of high sensitivity cardiac troponins

The increased sensitivity of high sensitivity cardiac troponin assays comes at a cost of decreased specificity, and “false positive” diagnosis of acute coronary syndromes has made clinicians wary of their use, fearing unnecessary hospitalisations, angiography and revascularisation. The Ethics and Guidelines Standing Committee of SA Heart Association convened a meeting of cardiologists, chemical...

متن کامل

Incorporating high-sensitivity cardiac troponin assays into clinical practice: these assays are your friend

The objective of this review is to provide an overview of the current analytical, clinical, and risk assessment status of cardiac troponin (cTn) high-sensitivity (hs) assays and on how to better understand their use in clinical practice. The introduction of hs-cTnI and hs-cTnT assays into clinical practice has enabled improved diagnostic accuracy using serial changes. However, there remains sub...

متن کامل

High-Sensitivity Troponin Assays: Boon or Bane for the Cardiologist?

The Troponin Era The advent of the “troponin era” has its roots in the redefi nition of acute myocardial infarction (AMI) by the joint committee of European and American cardiologists in 2000.1 Troponin was identifi ed as the preferred serologic biomarker for acute coronary syndrome (ACS). Since then, troponin assays have continued to evolve with improved sensitivity and reproducibility, leadin...

متن کامل

Determination of 19 cardiac troponin I and T assay 99th percentile values from a common presumably healthy population.

BACKGROUND Between-assay comparability of 99th percentiles for cardiac troponin concentrations has not been assessed systematically in a single population for a large number of assays. METHODS We determined 99th percentiles for 19 cardiac troponin assays in heparin plasma samples from a population of 272 and 252 presumably healthy males and females, respectively. The assays evaluated included...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 3  شماره 

صفحات  -

تاریخ انتشار 2014