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The Advantages of High-sensitivity Troponin Tests

High-sensitivity troponin tests detect circulating troponin at lower levels and provide improved diagnostic accuracy. These tests can also accelerate decision making. To qualify as true high-sensitivity troponin assays, these tests should:

  • Meet IFCC guidelines for high-sensitivity troponin testing1
    • Detect cTn above the Limit of Detection in >50% of healthy populations
    • Achieve <10% CV below the 99th percentile URL
  • Support current cardiac guidelines for patient management

The use of high-sensitivity troponin tests

When a patient comes to the emergency department with a suspected acute coronary syndrome, the speed and accuracy of the diagnostics have a critical impact on outcome and cost of care. (See Figure 1.) 

Figure 1. Breakdown of 10.4M Patients Present with Chest Pain to the Emergency Department Annually*

Infographic pie chart showing 10.4M patients present with chest pain to the ED annually, 60% with suspected cardiac cause*

High-sensitivity troponin tests drive fast decision making by:

  • Accurately identifying ≥94% of true AMI patients in as little as one hour after patient presentation
  • Enabling easier interpretation of test results by using whole-number reporting 
     

In addition, high-sensitivity troponin assays can:

  • Produce prognostic data to assess risk in a variety of clinical situations
  • Provide increased clarity to determine a patient's future risk

Better precision, better decisions

More sensitive cardiac troponin tests enable greater confidence in results, accelerate a clinician's ability to rule in (or rule out) myocardial infarction, and provide efficiency improvements in cardiac patient management. With more sensitive assays, more rapid serial sampling is now possible. In addition, they enable faster decisions about small changes in low levels of troponin over shorter periods of time.

The 2015 ESC Guidelines (see Figure 2) recommend sampling at 0 and 3 hours, integrating testing with detailed clinical assessment, and a mandatory 12-lead ECG and repeat blood sampling when a patient experiences recurring chest pain.2

Figure 2: 0/3 Hour Protocol Described By 2015 ESC Guidelines

Process flowchart describing 0/3 hour protocol

 

High-sensitivity troponin testing for your laboratory

Provide reliable results that physicians can use with confidence to make decisions about patient management. The Access hsTnI assay offers much greater precision at very low levels of troponin, which may help physicians may help interpret small changes in low levels of troponin over shorter periods of time. In addition, Access hsTnI utilizes a new robust design to minimize the effects of pre-analytical variability and known interferences. You can run Access hsTnI on any Access 2 or DxI series immunoassay analyzer.

Learn more about Access hsTnI ›

1Clinical Applications of Cardiac Bio-markers. IFCC: International Federation of Clinical Chemistry and Laboratory Medicine, 26 July 2014. Web. 14 Feb. 2017.

22015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. http://eurheartj.oxfordjournals.org. Last accessed on January 19, 2017.

*Figure 1: Adapted and used with permission from W. Frank Peacock, M.D., FACEP Baylor College of Medicine.

1% = 50,000 MIs after patient was sent home.

AMI = Acute Myocardial Infarction.

§UA = Unstable Angina.

GRACE = Global Registry of Acute Coronary Events score.

**ULN = upper limit of normal, 99th percentile of healthy controls.

††Δ change, dependent on assay. Highly abnormal hsTn defines values beyond 5-fold the upper limit of normal.

‡‡hs-cTn = high sensitivity cardiac troponin.