Clinical, organizational and economic analysis of high-sensitivity cardiac troponin testing in the emergency department

The measurement of cardiac troponins (cTns) has become the mainstay for the diagnosis of acute coronary syndrome (ACS), since the assessment of either cardiac troponin T (cTnT) or cardiac troponin I (cTnI) has now outperformed whatever other available biomarker, to be used alone or in combination with cTns (1). This paradigm shift has been strongly supported by recent introduction in clinical practice of the so-called high-sensitivity (HS) immunoassays, which have allowed to considerably enhance the functional and diagnostic sensitivity of the former “contemporary-sensitive” (CS) techniques, thus allowing a more efficient and faster patient management in short stay units such as the emergency department (ED) (2). Regardless of the many diagnostic protocols that have been developed so far for improving the clinical efficiency of cTns testing in diagnosing ACS, and entailing baseline Original Article