What to do when you question cardiac troponin values

Johannes Mair; Bertil Lindahl; Christian Müller; Evangelos Giannitsis; Kurt Huber; Martin Möckel; Mario Plebani; Kristian Thygesen; Allan S Jaffe

doi:10.1177/2048872617708973

What to do when you question cardiac troponin values

Johannes Mair, Bertil Lindahl, Christian Müller, Evangelos Giannitsis, Kurt Huber, Martin Möckel, Mario Plebani, Kristian Thygesen, Allan S Jaffe

Institut for Klinisk Medicin - Hjertesygdomme

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

77 Citationer (Scopus)

Abstract

High-sensitivity cardiac troponin assays enable cardiac troponin measurement with a high degree of analytical sensitivity and a low level of analytical imprecision at the low measuring range. One of the most important advantages of these new assays is that they allow novel, more rapid approaches for ruling in or ruling out acute myocardial infarctions. The increase in the early diagnostic sensitivity of high-sensitivity cardiac troponin assays comes at the cost of a reduced acute myocardial infarction specificity of the biomarker, because more patients with other causes of acute or chronic myocardial injury without overt myocardial ischaemia are detected than with previous cardiac troponin assays. Increased troponin concentrations that do not fit with the clinical presentation are seen in the daily routine, mainly as a result of a variety of pathologies, and if tested in the same sample, even discrepancies between high-sensitivity cardiac troponin I and troponin T test results may sometimes be found as well. In addition, analytically false-positive test results occasionally may occur since no assay is perfect. In this review, we summarise the biochemical, pathophysiological and analytical background of the work-up for such a clinical setting.

Originalsprog	Engelsk
Tidsskrift	European Heart Journal: Acute Cardiovascular Care
Vol/bind	7
Nummer	6
Sider (fra-til)	577-586
Antal sider	10
ISSN	2048-8726
DOI	https://doi.org/10.1177/2048872617708973
Status	Udgivet - 1 sep. 2018

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10.1177/2048872617708973

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AU - Mair, Johannes

AU - Lindahl, Bertil

AU - Müller, Christian

AU - Giannitsis, Evangelos

AU - Huber, Kurt

AU - Möckel, Martin

AU - Plebani, Mario

AU - Thygesen, Kristian

AU - Jaffe, Allan S

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AB - High-sensitivity cardiac troponin assays enable cardiac troponin measurement with a high degree of analytical sensitivity and a low level of analytical imprecision at the low measuring range. One of the most important advantages of these new assays is that they allow novel, more rapid approaches for ruling in or ruling out acute myocardial infarctions. The increase in the early diagnostic sensitivity of high-sensitivity cardiac troponin assays comes at the cost of a reduced acute myocardial infarction specificity of the biomarker, because more patients with other causes of acute or chronic myocardial injury without overt myocardial ischaemia are detected than with previous cardiac troponin assays. Increased troponin concentrations that do not fit with the clinical presentation are seen in the daily routine, mainly as a result of a variety of pathologies, and if tested in the same sample, even discrepancies between high-sensitivity cardiac troponin I and troponin T test results may sometimes be found as well. In addition, analytically false-positive test results occasionally may occur since no assay is perfect. In this review, we summarise the biochemical, pathophysiological and analytical background of the work-up for such a clinical setting.

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What to do when you question cardiac troponin values

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