Clinical application of sensitive cardiac troponin assays

TY - JOUR

T1 - Clinical application of sensitive cardiac troponin assays

T2 - Potential and limitations

AU - Twerenbold, Raphael

AU - Reichlin, Tobias

AU - Mueller, Christian

PY - 2010/6

Y1 - 2010/6

N2 - Acute myocardial infarction (AMI) is the major cause of death worldwide. Cardiac troponins (cTns) are structural proteins, unique to the heart, that currently form the cornerstone of the AMI diagnosis. The major limitation of standard cTn assays is a sensitivity deficit at presentation caused by a delayed increase of circulating levels. Recent multicenter studies have demonstrated that novel, more sensitive and precise cTn assays improve the early diagnosis of AMI. cTn has to be interpreted as a quantitative variable. The term 'troponin positive should, therefore, be avoided. 'Detectable levels will become the norm and have to be clearly differentiated from 'elevated levels. The differential diagnosis of a small amount of myocardial injury and, therefore, mild elevation of cTn is broad, and includes acute and chronic disorders. The differential diagnosis of a large amount of myocardial injury and, therefore, substantial elevation of cTn is much smaller and largely restricted to AMI, myocarditis and takotsubo cardiomyopathy. The aim of this article is to guide clinicians in the use of sensitive cTn.

AB - Acute myocardial infarction (AMI) is the major cause of death worldwide. Cardiac troponins (cTns) are structural proteins, unique to the heart, that currently form the cornerstone of the AMI diagnosis. The major limitation of standard cTn assays is a sensitivity deficit at presentation caused by a delayed increase of circulating levels. Recent multicenter studies have demonstrated that novel, more sensitive and precise cTn assays improve the early diagnosis of AMI. cTn has to be interpreted as a quantitative variable. The term 'troponin positive should, therefore, be avoided. 'Detectable levels will become the norm and have to be clearly differentiated from 'elevated levels. The differential diagnosis of a small amount of myocardial injury and, therefore, mild elevation of cTn is broad, and includes acute and chronic disorders. The differential diagnosis of a large amount of myocardial injury and, therefore, substantial elevation of cTn is much smaller and largely restricted to AMI, myocarditis and takotsubo cardiomyopathy. The aim of this article is to guide clinicians in the use of sensitive cTn.

KW - Acute myocardial infarction

KW - Diagnosis

KW - High sensitive troponin

KW - Sensitivity

KW - Specificity

UR - http://www.scopus.com/inward/record.url?scp=77953739243&partnerID=8YFLogxK

U2 - 10.2217/bmm.10.60

DO - 10.2217/bmm.10.60

M3 - SCORING: Review article

C2 - 20550473

AN - SCOPUS:77953739243

VL - 4

SP - 395

EP - 401

JO - BIOMARK MED

JF - BIOMARK MED

SN - 1752-0363

IS - 3

ER -