TY - JOUR
T1 - Incorporating high-sensitivity cardiac troponin assays into clinical practice
T2 - These assays are your friend
AU - Love, Sara
AU - Sandoval, Yader
AU - Apple, Fred S.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - The objective of this review is to provide an overview of the current analytical, clinical, and risk assessment status of cardiac troponin (cTn) high-sensitivity (hs) assays and on how to better understand their use in clinical practice. The introduction of hs-cTnI and hs-cTnT assays into clinical practice has enabled improved diagnostic accuracy using serial changes. However, there remains substantial investigative work to be done before coherent evidence-based guidelines can be established for the full spectrum of available assays. Not all cTn assays, I or T, are alike, whether contemporary sensitive or high-sensitivity. Each assay and each platform on which cTn is measured requires development of its own evidencebased delta criteria in order to support optimal use for patients presenting with symptoms suggestive of ischemia. The growth in utilization of hs-cTn assays will both improve diagnostics for early rule in and early rule out of patients presenting with symptoms suggestive of acute coronary syndrome (ACS). As for patients with non-ACS presentation and for primary and or secondary prevention for risk assessment, future therapeutic studies will best define the power of hs-cTn assays and their role in clinical practice. However, what we do know is that an increased cTn concentration indicates a poor outcome and need for increased clinical vigilance.
AB - The objective of this review is to provide an overview of the current analytical, clinical, and risk assessment status of cardiac troponin (cTn) high-sensitivity (hs) assays and on how to better understand their use in clinical practice. The introduction of hs-cTnI and hs-cTnT assays into clinical practice has enabled improved diagnostic accuracy using serial changes. However, there remains substantial investigative work to be done before coherent evidence-based guidelines can be established for the full spectrum of available assays. Not all cTn assays, I or T, are alike, whether contemporary sensitive or high-sensitivity. Each assay and each platform on which cTn is measured requires development of its own evidencebased delta criteria in order to support optimal use for patients presenting with symptoms suggestive of ischemia. The growth in utilization of hs-cTn assays will both improve diagnostics for early rule in and early rule out of patients presenting with symptoms suggestive of acute coronary syndrome (ACS). As for patients with non-ACS presentation and for primary and or secondary prevention for risk assessment, future therapeutic studies will best define the power of hs-cTn assays and their role in clinical practice. However, what we do know is that an increased cTn concentration indicates a poor outcome and need for increased clinical vigilance.
KW - Biomarkers
KW - Cardiac troponin
KW - Diagnostic accuracy
KW - High-sensitivity assays
KW - Myocardial infarction
KW - Outcomes
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UR - http://www.scopus.com/inward/citedby.url?scp=84938944007&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:84938944007
SN - 1566-0338
SP - 9
EP - 14
JO - Heart and Metabolism
JF - Heart and Metabolism
IS - 67
ER -