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Editor's Choice-What to do when you question cardiac troponin values
Med Univ Innsbruck, Heart Ctr, Dept Internal Med Cardiol & Angiol 3, Innsbruck, Austria.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.ORCID iD: 0000-0002-5795-0061
Univ Basel Hosp, Dept Cardiol, Basel, Switzerland; Univ Basel Hosp, Cardiovasc Res Inst Basel, Basel, Switzerland.
Heidelberg Univ, Dept Cardiol, Med Klin 3, Heidelberg, Germany.
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2018 (English)In: European heart journal. Acute cardiovascular care., ISSN 2048-8726, Vol. 7, no 6, p. 577-586Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2018. Vol. 7, no 6, p. 577-586
Keywords [en]
Cardiac troponin I, cardiac troponin T, high sensitivity, discrepancy, interference, mismatch
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-366277DOI: 10.1177/2048872617708973ISI: 000444973300011PubMedID: 28485179OAI: oai:DiVA.org:uu-366277DiVA, id: diva2:1265775
Available from: 2018-11-26 Created: 2018-11-26 Last updated: 2018-11-26Bibliographically approved

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