The Advantages of High Sensitivity Troponin Tests

High sensitivity troponin tests detect circulating troponin at lower levels and provide improved diagnostic clarity. These tests can accelerate decision making and improve patient care. 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
  • Provide sex-specific thresholds that may generate more accurate diagnoses for women

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.) High sensitivity troponin tests drive fast decision making by:

  • Reducing triage time by hours, sending MI-negative patients home faster2
  • Detecting at-risk patients sooner3

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

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*

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, improve care and increase efficiency. With more sensitive assays, more rapid serial sampling is now possible. The ability to rule in earlier allows patients to be triaged down the appropriate care pathway, while ruling out earlier can lead to faster discharge.

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.4

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

Process flowchart describing 0/3 hour protocol


Learn more

Request more information about high sensitivity troponin assays by contacting your local Beckman Coulter sales representative.

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

2Storrow, AB et al. Diagnostic Performance of Cardiac Troponin I For Early Rule-in and Rule-out of Acute Myocardial Infarction: Results of a Prospective Multicenter Trial. Clinical Biochemistry, 2015; 48:254-259.

3Thygesen K, Mair J, Giannitsis E, Mueller C, Lindahl B, Blankenberg S, et al. How to use high-sensitivity cardiac troponins in acute cardiac care. Eur Heart J 2012; 33: 2252-7. Korley FK, Jaffe AS. Preparing the United States for high-sensitivity cardiac troponin assays. J Am Coll Cardiol, 2013; 61:1753-8.

42015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. 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.