What to do when you question cardiac troponin values

• Verfasst von: Mair, Johannes [VerfasserIn]
• Verfasst von: Giannitsis, Evangelos [VerfasserIn]
• Titel: What to do when you question cardiac troponin values
• Verf.angabe: Johannes Mair, Bertil Lindahl, Christian Müller, Evangelos Giannitsis, Kurt Huber, Martin Möckel, Mario Plebani, Kristian Thygesen and Allan S Jaffe
• Jahr: 2018
• Jahr des Originals: 2017
• Umfang: 10 S.
• Fussnoten: First published May 9, 2017 ; Gesehen am 22.08.2018
• Titel Quelle: Enthalten in: European heart journal - acute cardiovascular care
• Ort Quelle: London [u.a.] : Sage Publ., 2012
• Jahr Quelle: 2018
• Band/Heft Quelle: 7(2018), 6, Seite 577-586
• ISSN Quelle: 2048-8734
• DOI: doi:10.1177/2048872617708973
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1580298435

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.