How Does the Analytical Quality of the High-Sensitivity Cardiac Troponin T Assay Affect the ESC Rule Out Algorithm for NSTEMI?

• Published in: Clinical chemistry (Baltimore, Md.) Vol. 65; no. 3; pp. 494 - 496
• Main Authors: Haagensen, Kristin, Collinson, Paul, Åsberg, Arne, Aakre, Kristin M
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.03.2019
• Subjects: Abbreviations; Algorithms; Angina pectoris; Bias; Biological variation; Biomarkers - blood; Blood Chemical Analysis - statistics & numerical data; Calcium-binding protein; Cardiology; Clinching; Heart; Heart attacks; Humans; Laboratories; Mathematical analysis; Myocardial infarction; Non-ST Elevated Myocardial Infarction - diagnosis; Sensitivity analysis; Statistical analysis; Troponin; Troponin T; Troponin T - blood; Values; United Kingdom > UK; Norway
• ISSN: 0009-9147; 1530-8561; 1530-8561
• DOI: 10.1373/clinchem.2018.298703

The ESC algorithm requires that a difference of <3 ng/L can be detected (4) and, by implication, that there is an absolute RCV (8) value of <3 ng/L. Because cardiac troponin is reported in whole numbers, the actual lowest detectable 8 value should be 2 ng/L. [...]the hs-cTnT assay showed satisfactory analytical precision when using 2 Cobas e801 modules, but laboratories should still verify their CVA locally before implementing the ESC rule-out algorithm. Hormone Laboratory Haukeland University Hospital PO Box 1400 5021 Bergen, Norway E-mail kristin.moberg.aakre@helse-bergen.no Previously published online at DOI: 10.1373/clinchem.2018.298703 1 Nonstandard abbreviations: ESC, European Society of Cardiology; NSTEMI, non-ST elevation myocardial infarction; hs-cTnT, high-sensitivity cardiac troponin T; CVA, analytical variation; RCV, reference change values; CV,, intra-individual biological variation.