Preparing the United States for High-Sensitivity Cardiac Troponin Assays
It is only a matter of time before the use of high-sensitivity cardiac troponin assays (hs-cTn) becomes common throughout the United States. In preparation for this inevitability, this article raises a number of important issues regarding these assays that deserve consideration. These include: the n...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2013-04, Vol.61 (17), p.1753-1758 |
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| creator | Korley, Frederick K., MD Jaffe, Allan S., MD |
| description | It is only a matter of time before the use of high-sensitivity cardiac troponin assays (hs-cTn) becomes common throughout the United States. In preparation for this inevitability, this article raises a number of important issues regarding these assays that deserve consideration. These include: the need for the adoption of a universal nomenclature; the importance of defining uniform criteria for reference populations; the challenge of discriminating between acute and nonacute causes of hs-cTn elevations, and between type 1 and type 2 acute myocardial infarction (AMI); factors influencing the analytical precision of hs-cTn; ascertaining the optimal duration of the rule-out period for AMI; the need for further evaluation to determine the causes of a positive hs-cTn in non-AMI patients; and the use of hs-cTn to risk-stratify patients with disease conditions other than AMI. This review elaborates on these critical issues as a means of educating clinicians and researchers about them. |
| doi_str_mv | 10.1016/j.jacc.2012.09.069 |
| format | Article |
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In preparation for this inevitability, this article raises a number of important issues regarding these assays that deserve consideration. These include: the need for the adoption of a universal nomenclature; the importance of defining uniform criteria for reference populations; the challenge of discriminating between acute and nonacute causes of hs-cTn elevations, and between type 1 and type 2 acute myocardial infarction (AMI); factors influencing the analytical precision of hs-cTn; ascertaining the optimal duration of the rule-out period for AMI; the need for further evaluation to determine the causes of a positive hs-cTn in non-AMI patients; and the use of hs-cTn to risk-stratify patients with disease conditions other than AMI. This review elaborates on these critical issues as a means of educating clinicians and researchers about them.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2012.09.069</identifier><identifier>PMID: 23395074</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Acute coronary syndromes ; Acute Disease ; Biological and medical sciences ; Biomarkers - blood ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Chronic Disease ; Diagnosis, Differential ; Heart ; Heart attacks ; Heart failure ; high-sensitivity troponin ; Humans ; Internal Medicine ; ischemia ; Medical imaging ; Medical sciences ; Mortality ; myocardial infarction ; Myocardial Infarction - blood ; Myocardial Infarction - diagnosis ; NMR ; Nuclear magnetic resonance ; Older people ; Patient Selection ; Sensitivity and Specificity ; Terminology as Topic ; Troponin - blood ; United States</subject><ispartof>Journal of the American College of Cardiology, 2013-04, Vol.61 (17), p.1753-1758</ispartof><rights>American College of Cardiology Foundation</rights><rights>2013 American College of Cardiology Foundation</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. 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In preparation for this inevitability, this article raises a number of important issues regarding these assays that deserve consideration. These include: the need for the adoption of a universal nomenclature; the importance of defining uniform criteria for reference populations; the challenge of discriminating between acute and nonacute causes of hs-cTn elevations, and between type 1 and type 2 acute myocardial infarction (AMI); factors influencing the analytical precision of hs-cTn; ascertaining the optimal duration of the rule-out period for AMI; the need for further evaluation to determine the causes of a positive hs-cTn in non-AMI patients; and the use of hs-cTn to risk-stratify patients with disease conditions other than AMI. 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Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Chronic Disease</subject><subject>Diagnosis, Differential</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>high-sensitivity troponin</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>ischemia</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Mortality</subject><subject>myocardial infarction</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - diagnosis</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Older people</subject><subject>Patient Selection</subject><subject>Sensitivity and Specificity</subject><subject>Terminology as Topic</subject><subject>Troponin - blood</subject><subject>United States</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl1r1EAUhgdR7Fr9A15IQARvEs_MZCYZEKEstisUFLYF74bZk5N2YjZZZ7KF_fdO2NVCL7w6N897Ph4OY285FBy4_tQVnUMsBHBRgClAm2dswZWqc6lM9ZwtoJIq52CqM_Yqxg4AdM3NS3YmpDQKqnLBVj8C7Vzww1023VN2O_iJmmw9uYli1o4hW_m7-3xNQ_STf_DTIVu60HiH2U0Yd-Pgh-wiRneIr9mL1vWR3pzqObu9_HqzXOXX36--LS-uc1RcTrmoUbtSYFPWotayNEI30gChRs4Rq3YDWitndAsVcA5OC0K-MYSqBSedPGcfj313Yfy9pzjZrY9Ife8GGvfRcllqVdVGQELfP0G7cR-GtJ3lulQCVC15osSRwjDGGKi1u-C3LhwsBzt7tp2dPdvZswVjk-cUendqvd9sqfkX-Ss2AR9OgIvo-ja4AX185CopBJg6cZ-PHCVnD56CjehpQGp8IJxsM_r_7_HlSRx7P_g08RcdKD7ea2PK2PX8EfNDcAnAa_VT_gHitK5R</recordid><startdate>20130430</startdate><enddate>20130430</enddate><creator>Korley, Frederick K., MD</creator><creator>Jaffe, Allan S., MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20130430</creationdate><title>Preparing the United States for High-Sensitivity Cardiac Troponin Assays</title><author>Korley, Frederick K., MD ; Jaffe, Allan S., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c513t-28c6a42cd4828634926d390ec6c11cc7fb0665a96f070110a62ec1b9ec5f0a3a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Acute coronary syndromes</topic><topic>Acute Disease</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Cardiology</topic><topic>Cardiology. 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| subjects | Acute coronary syndromes Acute Disease Biological and medical sciences Biomarkers - blood Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease Chronic Disease Diagnosis, Differential Heart Heart attacks Heart failure high-sensitivity troponin Humans Internal Medicine ischemia Medical imaging Medical sciences Mortality myocardial infarction Myocardial Infarction - blood Myocardial Infarction - diagnosis NMR Nuclear magnetic resonance Older people Patient Selection Sensitivity and Specificity Terminology as Topic Troponin - blood United States |
| title | Preparing the United States for High-Sensitivity Cardiac Troponin Assays |
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