Thursday, June 12, 2014

Circ - Troponin Interpretation

"Clinician Update How to Interpret Elevated Cardiac Troponin Levels"
http://circ.ahajournals.org/content/124/21/2350.full
"Assays for cTn, namely cTnI and cardiac troponin T (cTnT), are the preferred diagnostic tests for ACS, in particular non–ST-segment–elevation myocardial infarction, because of the tissue-specific expression of cTnI and cTnT in the myocardium. The results of cTn testing often guide the decision for coronary intervention. However, although the increasing sensitivity of cTn assays lowers the number of potentially missed ACS diagnoses, it presents a diagnostic challenge because the gains in diagnostic sensitivity have inevitably come with a decrease in specificity. For instance, the replacement of the cTn assay (Siemens Healthcare Diagnostics) by the more sensitive TnI-UItra assay in the Brigham and Women's Hospital Clinical Laboratories in early 2007 resulted in a doubling of positive cTn results in samples collected in the emergency department2 even though there was no change in the frequency of final diagnoses of ACS."

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