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Myocardial Infarction Risk Stratification With a Single Measurement of High-Sensitivity Troponin I Inflammatory Bowel Disease and Acute Coronary Syndromes: From Pathogenesis to the Fine Line Between Bleeding and Ischemic Risk Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial Association between Coronary Collaterals and Myocardial Viability in Patients with a Chronic Total Occlusion Clinical Characteristics and Outcomes of STEMI Patients With Cardiogenic Shock and Cardiac Arrest Unloading the Left Ventricle Before Reperfusion in Patients With Anterior ST-Segment-Elevation Myocardial Infarction Long-Term Outcomes of Patients With Late Presentation of ST-Segment Elevation Myocardial Infarction Macrophage MST1/2 Disruption Impairs Post-Infarction Cardiac Repair via LTB4 Acute Microvascular Impairment Post-Reperfused STEMI Is Reversible and Has Additional Clinical Predictive Value: A CMR OxAMI Study Current Smoking and Prognosis After Acute ST-Segment Elevation Myocardial Infarction: New Pathophysiological Insights

Expert Opinion2019 Feb 16. [Epub ahead of print]

JOURNAL:J Am Coll Cardiol. Article Link

Recommendations for Institutions Transitioning to High-Sensitivity Troponin Testing JACC Scientific Expert Panel

Januzzi JL Jr, Mahler SA, Christenson RH et al. Keywords: laboratory testing; myocardial infarction; troponin

ABSTRACT


High-sensitivity cardiac troponin (hs-cTn) I or T methods have been in use in certain regions for years but are now increasingly globally adopted, including in the United States. Accordingly, inevitable challenges are created for institutions transitioning from conventional cardiac troponin (cTn) assays. hs-cTn assays have higher analytic precision at lower concentrations, yielding greater clinical sensitivity for myocardial injury and allowing accurate recognition of small changes in troponin concentration (rise or fall) within a short time frame. Although much of the knowledge regarding troponin biology that was applicable with older troponin assays still holds true, considerable education regarding the differences between conventional cTn and hs-cTn is needed before medical systems convert to the newer methods. This includes a basic understanding of how hs-cTn testing differs from conventional cTn testing and how it is best deployed in different settings, such as the emergency department and inpatient services. This Expert Panel will review important concepts for institutional transition to hs-cTn methodology, providing recommendations useful for education before implementation.


Copyright ? 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.