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What to do when you question cardiac troponin values

Authors :
Mair, Johannes
Lindahl, Bertil
Müller, Christian
Giannitsis, Evangelos
Huber, Kurt
Möckel, Martin
Plebani, Mario
Thygesen, Kristian
Jaffe, Allan S
Source :
European Heart Journal : Acute Cardiovascular Care; September 2018, Vol. 7 Issue: 6 p577-586, 10p
Publication Year :
2018

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.

Details

Language :
English
ISSN :
20488726 and 20488734
Volume :
7
Issue :
6
Database :
Supplemental Index
Journal :
European Heart Journal : Acute Cardiovascular Care
Publication Type :
Periodical
Accession number :
ejs46548805
Full Text :
https://doi.org/10.1177/2048872617708973