EditorialCardiac troponin testing in the acute care setting: Ordering, reporting, and high sensitivity assays—An update from the Canadian society of clinical chemists (CSCC)
Section snippets
Time intervals for measurement of cTn in the acute hospital setting
The Joint ESC/ACCF/AHA/WHF Task Force's Universal Definition of MI and the National Academy of Clinical Biochemistry practice guidelines on the utilization of biochemical markers in acute coronary syndromes (ACS) have indicated that patients with symptoms suggestive of ACS should undergo blood sampling for cTn levels at hospital presentation and 6–9 hours later [1], [15]. However, there are data indicating that measurements as early as 3 hours after presentation to the emergency department may
Requirements and suggestion for implementing hs-cTn assays
Discussion and debate continue over what constitutes a high sensitivity cTn assay [19], [20]. Perhaps the most easily understood concept considers the percentage of detectable concentrations of cTn in individuals with absence of overt disease [21]. In this regard, the actual percentage may vary and will change as vendors develop increasingly sensitive cTn assays [22]. As a starting point the cTn assay should be capable of detecting cTn in greater than 50% of the non-ACS and ambulatory
Disclosures
Dr. Kavsak has received speaker fees and/or grant support from the following diagnostic companies that manufacture cardiac troponin assays: Abbott, Beckman Coulter, Ortho Clinical Diagnostics, Randox, Roche. Dr. Apple has been a paid consultant for Abbott, Ortho Clinical Diagnostics, Beckman Coulter and Instrumentation Laboratories; has served on advisory boards for Ortho Clinical Diagnostics, Alere/Biosite and Instrumentation Laboratories; has received research grant funding from Abbott
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2017, Clinical BiochemistryCitation Excerpt :Adopting ethical guidelines for publishing [84] First laboratory society document on high-sensitivity cardiac troponin assays [85] Larger studies assessing pre-analytical stability [86] and multi-assay comparisons [87]
Impact of lipid markers and high-sensitivity C-reactive protein on the value of the 99th percentile upper reference limit for high-sensitivity cardiac troponin I
2016, Clinica Chimica ActaCitation Excerpt :According to the Third Universal Definition of Myocardial Infarction, the 99th percentile URL should be determined in a normal reference population for each specific assay with appropriate quality control in each laboratory [1]. Importantly, recently endorsed high-sensitivity cardiac troponin (hs-cTn) assays with their improved precision at the 99th percentile URL are able to detect measurable cTn concentrations in a substantial proportion of healthy individuals and have been proven to facilitate clinical decision making in patients with suspected MI [2–10]. The selection of a normal reference population for the 99th percentile URL determination remains a critical but also controversial issue as the characteristics of the reference population have a profound effect on the 99th percentile URL value.