Clinical Use of High-Sensitivity Cardiac Troponin in Patients With Suspected Myocardial Infarction

High-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since their clinical introduction 7 years ago. In the early diagnosis of myocardial infarction (MI), beyond doubt, the most important indication of hs-cTn ass...

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Published inJournal of the American College of Cardiology Vol. 70; no. 8; pp. 996 - 1012
Main Authors Twerenbold, Raphael, Boeddinghaus, Jasper, Nestelberger, Thomas, Wildi, Karin, Rubini Gimenez, Maria, Badertscher, Patrick, Mueller, Christian
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 22.08.2017
Elsevier Limited
Subjects
Acute coronary syndromes
algorithm
Algorithms
Biomarkers - blood
Calcium-binding protein
Cardiology
Cardiomyocytes
Cardiovascular
Cardiovascular disease
diagnostic algorithms
Early Diagnosis
EKG
Electrocardiography
emergency department
Health risk assessment
Heart
Heart attacks
Heart diseases
Heart failure
high-sensitivity cardiac troponin
Humans
Medical diagnosis
Medical prognosis
Myocardial infarction
Myocardial Infarction - blood
Myocardial Infarction - diagnosis
Pain
Patients
rule-in
rule-out
Survival analysis
Troponin
Troponin I - blood
Troponin T - blood
Europe
NSTEMI
FDA
s-cTn
UA
ADP
rule-out
CCTA
ESC
LBBB
MACE
NPV
PPV
STEMI
hs-cTn
rule-in
MI
high-sensitivity cardiac troponin
algorithm
ED
diagnostic algorithms
CAD
ECG
emergency department
ACS
TIMI
cTn
coronary artery disease
positive predictive value
advanced diagnostic pathway
myocardial infarction
Thrombolysis In Myocardial Infarction
electrocardiogram
acute coronary syndrome
Food and Drug Administration
non–ST-segment elevation myocardial infarction
coronary computed tomography angiography
cardiac troponin
left bundle branch block
major adverse cardiac event(s)
European Society of Cardiology
ST-segment elevation myocardial infarction
unstable angina
negative predictive value
sensitive cardiac troponin
Online AccessGet full text
ISSN0735-1097
1558-3597
1558-3597
DOI10.1016/j.jacc.2017.07.718

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Abstract High-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since their clinical introduction 7 years ago. In the early diagnosis of myocardial infarction (MI), beyond doubt, the most important indication of hs-cTn assays, these simple, inexpensive, and highly reproducible tools complement detailed clinical assessment including chest pain characteristics and the electrocardiogram. Hs-cTn assays for the first time allowed the precise quantification of cardiomyocyte injury around the 99th percentile and thereby substantially increased the accuracy of MI detection from blood obtained at presentation to the emergency department (ED). Higher accuracy at ED presentation enabled the development and extensive validation of early hs-cTn–based diagnostic algorithms, which substantially reduced the time required for the safe rule-out or rule-in of MI. This review summarizes key principles underlying the safe and effective use of hs-cTn in the ED in patients with suspected MI. [Display omitted]
AbstractList High-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since their clinical introduction 7 years ago. In the early diagnosis of myocardial infarction (MI), beyond doubt, the most important indication of hs-cTn assays, these simple, inexpensive, and highly reproducible tools complement detailed clinical assessment including chest pain characteristics and the electrocardiogram. Hs-cTn assays for the first time allowed the precise quantification of cardiomyocyte injury around the 99th percentile and thereby substantially increased the accuracy of MI detection from blood obtained at presentation to the emergency department (ED). Higher accuracy at ED presentation enabled the development and extensive validation of early hs-cTn-based diagnostic algorithms, which substantially reduced the time required for the safe rule-out or rule-in of MI. This review summarizes key principles underlying the safe and effective use of hs-cTn in the ED in patients with suspected MI.
AbstractHigh-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since their clinical introduction 7 years ago. In the early diagnosis of myocardial infarction (MI), beyond doubt, the most important indication of hs-cTn assays, these simple, inexpensive, and highly reproducible tools complement detailed clinical assessment including chest pain characteristics and the electrocardiogram. Hs-cTn assays for the first time allowed the precise quantification of cardiomyocyte injury around the 99th percentile and thereby substantially increased the accuracy of MI detection from blood obtained at presentation to the emergency department (ED). Higher accuracy at ED presentation enabled the development and extensive validation of early hs-cTn–based diagnostic algorithms, which substantially reduced the time required for the safe rule-out or rule-in of MI. This review summarizes key principles underlying the safe and effective use of hs-cTn in the ED in patients with suspected MI.
High-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since their clinical introduction 7 years ago. In the early diagnosis of myocardial infarction (MI), beyond doubt, the most important indication of hs-cTn assays, these simple, inexpensive, and highly reproducible tools complement detailed clinical assessment including chest pain characteristics and the electrocardiogram. Hs-cTn assays for the first time allowed the precise quantification of cardiomyocyte injury around the 99th percentile and thereby substantially increased the accuracy of MI detection from blood obtained at presentation to the emergency department (ED). Higher accuracy at ED presentation enabled the development and extensive validation of early hs-cTn–based diagnostic algorithms, which substantially reduced the time required for the safe rule-out or rule-in of MI. This review summarizes key principles underlying the safe and effective use of hs-cTn in the ED in patients with suspected MI. [Display omitted]
High-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since their clinical introduction 7 years ago. In the early diagnosis of myocardial infarction (MI), beyond doubt, the most important indication of hs-cTn assays, these simple, inexpensive, and highly reproducible tools complement detailed clinical assessment including chest pain characteristics and the electrocardiogram. Hs-cTn assays for the first time allowed the precise quantification of cardiomyocyte injury around the 99th percentile and thereby substantially increased the accuracy of MI detection from blood obtained at presentation to the emergency department (ED). Higher accuracy at ED presentation enabled the development and extensive validation of early hs-cTn-based diagnostic algorithms, which substantially reduced the time required for the safe rule-out or rule-in of MI. This review summarizes key principles underlying the safe and effective use of hs-cTn in the ED in patients with suspected MI.High-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since their clinical introduction 7 years ago. In the early diagnosis of myocardial infarction (MI), beyond doubt, the most important indication of hs-cTn assays, these simple, inexpensive, and highly reproducible tools complement detailed clinical assessment including chest pain characteristics and the electrocardiogram. Hs-cTn assays for the first time allowed the precise quantification of cardiomyocyte injury around the 99th percentile and thereby substantially increased the accuracy of MI detection from blood obtained at presentation to the emergency department (ED). Higher accuracy at ED presentation enabled the development and extensive validation of early hs-cTn-based diagnostic algorithms, which substantially reduced the time required for the safe rule-out or rule-in of MI. This review summarizes key principles underlying the safe and effective use of hs-cTn in the ED in patients with suspected MI.
Author Badertscher, Patrick
Rubini Gimenez, Maria
Wildi, Karin
Boeddinghaus, Jasper
Mueller, Christian
Twerenbold, Raphael
Nestelberger, Thomas
Author_xml – sequence: 1
  givenname: Raphael
  surname: Twerenbold
  fullname: Twerenbold, Raphael
  organization: Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
– sequence: 2
  givenname: Jasper
  surname: Boeddinghaus
  fullname: Boeddinghaus, Jasper
  organization: Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
– sequence: 3
  givenname: Thomas
  surname: Nestelberger
  fullname: Nestelberger, Thomas
  organization: Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
– sequence: 4
  givenname: Karin
  surname: Wildi
  fullname: Wildi, Karin
  organization: Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
– sequence: 5
  givenname: Maria
  surname: Rubini Gimenez
  fullname: Rubini Gimenez, Maria
  organization: Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
– sequence: 6
  givenname: Patrick
  surname: Badertscher
  fullname: Badertscher, Patrick
  organization: Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
– sequence: 7
  givenname: Christian
  surname: Mueller
  fullname: Mueller, Christian
  email: christian.mueller@usb.ch
  organization: Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28818210$$D View this record in MEDLINE/PubMed
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Keywords NSTEMI
FDA
s-cTn
UA
ADP
rule-out
CCTA
ESC
LBBB
MACE
NPV
PPV
STEMI
hs-cTn
rule-in
MI
high-sensitivity cardiac troponin
algorithm
ED
diagnostic algorithms
CAD
ECG
emergency department
ACS
TIMI
cTn
coronary artery disease
positive predictive value
advanced diagnostic pathway
myocardial infarction
Thrombolysis In Myocardial Infarction
electrocardiogram
acute coronary syndrome
Food and Drug Administration
non–ST-segment elevation myocardial infarction
coronary computed tomography angiography
cardiac troponin
left bundle branch block
major adverse cardiac event(s)
European Society of Cardiology
ST-segment elevation myocardial infarction
unstable angina
negative predictive value
sensitive cardiac troponin
Language English
License This article is made available under the Elsevier license.
Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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Snippet High-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since their...
AbstractHigh-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since...
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SubjectTerms Acute coronary syndromes
algorithm
Algorithms
Biomarkers - blood
Calcium-binding protein
Cardiology
Cardiomyocytes
Cardiovascular
Cardiovascular disease
diagnostic algorithms
Early Diagnosis
EKG
Electrocardiography
emergency department
Health risk assessment
Heart
Heart attacks
Heart diseases
Heart failure
high-sensitivity cardiac troponin
Humans
Medical diagnosis
Medical prognosis
Myocardial infarction
Myocardial Infarction - blood
Myocardial Infarction - diagnosis
Pain
Patients
rule-in
rule-out
Survival analysis
Troponin
Troponin I - blood
Troponin T - blood
Title Clinical Use of High-Sensitivity Cardiac Troponin in Patients With Suspected Myocardial Infarction
URI https://www.clinicalkey.com/#!/content/1-s2.0-S0735109717387776
https://www.clinicalkey.es/playcontent/1-s2.0-S0735109717387776
https://dx.doi.org/10.1016/j.jacc.2017.07.718
https://www.ncbi.nlm.nih.gov/pubmed/28818210
https://www.proquest.com/docview/1929786985
https://www.proquest.com/docview/1930484603
Volume 70
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