We have located links that may give you full text access.
Journal Article
Review
The clinical need for high-sensitivity cardiac troponin assays for acute coronary syndromes and the role for serial testing.
American Heart Journal 2008 Februrary
BACKGROUND: Cardiac troponin is the biomarker of choice for the serologic diagnosis of acute coronary syndromes. International cardiology and laboratory medicine guidelines have suggested that the cutoff concentration be set at the 99th percentile of a healthy population, with an assay imprecision of 10% or less. Unfortunately, most commercial troponin assays do not have the sensitivity and precision to reliably detect troponin in sera of healthy subjects. Therefore, there is a need to develop troponin assays with higher sensitivity, which cannot be achieved while also improving the assay's precision.
METHODS AND RESULTS: Novel prototype analytical testing devices have been developed that are 5- to 10-fold more sensitive than existing commercial troponin assays. These tests should enable an earlier detection of myocardial infarction relative to the time of presentation and detect a higher percentage of emergency department chest pain patients who are at risk for short-term major adverse cardiac events. However, use of a high-sensitivity troponin assay will also result in detection of more patients who have cardiac necrosis due to a nonischemic etiology.
CONCLUSIONS: Serial troponin testing will be necessary to determine the clinical significance of low levels of troponin release with use of high-sensitivity assays. Guidelines will need to be established to determine a change in troponin results that is statistically and clinically significant, and new considerations for the time interval needed between blood collections. This will enable the use of future high-sensitivity troponin assays to be more valuable.
METHODS AND RESULTS: Novel prototype analytical testing devices have been developed that are 5- to 10-fold more sensitive than existing commercial troponin assays. These tests should enable an earlier detection of myocardial infarction relative to the time of presentation and detect a higher percentage of emergency department chest pain patients who are at risk for short-term major adverse cardiac events. However, use of a high-sensitivity troponin assay will also result in detection of more patients who have cardiac necrosis due to a nonischemic etiology.
CONCLUSIONS: Serial troponin testing will be necessary to determine the clinical significance of low levels of troponin release with use of high-sensitivity assays. Guidelines will need to be established to determine a change in troponin results that is statistically and clinically significant, and new considerations for the time interval needed between blood collections. This will enable the use of future high-sensitivity troponin assays to be more valuable.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app