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High sensitivity troponin, analytical advantages, clinical benefits and clinical challenges - An update.

Collinson, P (2021) High sensitivity troponin, analytical advantages, clinical benefits and clinical challenges - An update. Clin Biochem, 91. pp. 1-8. ISSN 1873-2933 https://doi.org/10.1016/j.clinbiochem.2021.02.001
SGUL Authors: Collinson, Paul

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Abstract

The measurement of cardiac troponin (cTn) by a high sensitivity method now represents the standard method for cTn measurement in the laboratory. High sensitivity method are not measuring a novel form of troponin but have undergone methodological improvement in assay sensitivity to allow both very low level detection and repeat measurements at low levels with very low degrees of analytical imprecision. The methods identify additional patients with myocardial injury who would benefit from evidence-based interventions. Rapid predictive algorithms utilising measurement on admission as well as short sampling periods (1-2 h) allow much more rapid categorisation of patients to appropriate clinical pathways. The shift in the diagnosis from traditional "cardiac enzymes" to troponin based on the 99th percentile has accounted for the majority of the detection of myocardial injury in patients without acute coronary syndromes. These patients have a worse prognosis irrespective of the underlying cause of their hospital admission. The appropriate management strategy in this group, beyond managing the underlying problem, remains to be defined. Measurement of cTn in otherwise asymptomatic individuals may have a role for patient selection for preventive treatment or for patients monitoring. Clinical trials in this area are awaited.

Item Type: Article
Additional Information: © 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Acute coronary syndromes, Cardiac Troponin I, Cardiac Troponin T, High sensitivity, Myocardial infarction, Troponin, Acute coronary syndromes, Cardiac Troponin I, Cardiac Troponin T, High sensitivity, Myocardial infarction, Troponin, 1101 Medical Biochemistry and Metabolomics, General Clinical Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Clin Biochem
ISSN: 1873-2933
Language: eng
Dates:
DateEvent
May 2021Published
19 February 2021Published Online
5 February 2021Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 33610525
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113043
Publisher's version: https://doi.org/10.1016/j.clinbiochem.2021.02.001

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