1. The Asia-Pacific Society of Cardiology (APSC) Expert Committee Consensus Recommendations for Assessment of Suspected Acute Coronary Syndrome Using High-Sensitivity Cardiac Troponin T in the Emergency Department
- Author
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Ho Thuong Dung, Tar Choon Aw, Chien-Chang Lee, Arintaya Phrommintikul, Antonia Anna Lukito, Laila AbdelWareth, Wei Chieh Jack Tan, Sazzli Kasim, Masayuki Shiozaki, Tom Devasia, Martin Than, Yi-Heng Li, Fang Yeh Chu, Swee Han Lim, Evangelos Giannitsis, Federick Cheng, Derek P. Chew, Kenji Inoue, and Jong-Chan Youn
- Subjects
medicine.medical_specialty ,Acute coronary syndrome ,Consensus ,Cardiac troponin ,Special populations ,Cardiology ,Diagnostic Techniques, Cardiovascular ,030204 cardiovascular system & hematology ,Expert committee ,Decision Support Techniques ,03 medical and health sciences ,0302 clinical medicine ,Asia pacific ,Troponin T ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Acute Coronary Syndrome ,Societies, Medical ,Health professionals ,business.industry ,Decision Trees ,Reproducibility of Results ,General Medicine ,Emergency department ,Prognosis ,musculoskeletal system ,medicine.disease ,Up-Regulation ,Cardiology Service, Hospital ,Emergency Service, Hospital ,Cardiology and Cardiovascular Medicine ,business ,Algorithms ,Biomarkers - Abstract
The Asia-Pacific Society of Cardiology (APSC) high-sensitivity troponin T (hs-TnT) consensus recommendations and rapid algorithm were developed to provide guidance for healthcare professionals in the Asia-Pacific region on assessing patients with suspected acute coronary syndrome (ACS) using a hs-TnT assay. Experts from Asia-Pacific convened in 2 meetings to develop evidence-based consensus recommendations and an algorithm for appropriate use of the hs-TnT assay. The Expert Committee defined a cardiac troponin assay as a high-sensitivity assay if the total imprecision is ≤10% at the 99th percentile of the upper reference limit and measurable concentrations below the 99th percentile are attainable with an assay at a concentration value above the assay's limit of detection for at least 50% of healthy individuals. Recommendations for single-measurement rule-out/rule-in cutoff values, as well as for serial measurements, were also developed. The Expert Committee also adopted similar hs-TnT cutoff values for men and women, recommended serial hs-TnT measurements for special populations, and provided guidance on the use of point-of-care troponin T devices in individuals suspected of ACS. These recommendations should be used in conjunction with all available clinical evidence when making the diagnosis of ACS.
- Published
- 2020
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