A paradigm shift has occurred with the advent of high-sensitivity cardiac troponin (hs-cTn) testing; whereby a low, measurable normal cardiac troponin concentration provides important information—something that was not possible with previous versions of the test due to the higher analytical sensitivity of the non-hs-cTn assays. In the emergency department, seizing on the improved analytical capabilities, shorter testing protocols: 0/1 hour, 0/2 hour, 0/3 hour can be performed applying cutoffs below and above the 99th percentile upper reference limit with different deltas to further improve a clinicians ability to rule-in and rule-out myocardial infarction. This lecture will review key analytical and clinical aspects when using hs-cTn assays in the emergency setting.
WHAT YOU WILL LEARN
- The analytical attributes of a high-sensitivity cardiac troponin assay
- How to plan quality control testing specific for high-sensitivity cardiac troponin testing
- How to evaluate the strengths and weaknesses for earlier testing protocols for high-sensitivity cardiac troponin testing in the emergency setting
Peter Kavsak, PhD
Hamilton Regional Laboratory Medicine Program
Jurayinski Hospital and Cancer Centre
Hamilton, Ontario CAN.
This activity is approved for 1.5 ACCENT continuing education credits. Activity ID# 1993. This activity was planned in accordance with ACCENT Standards and Policies.