How to interpret elevated cardiac troponin levels
VS Mahajan, P Jarolim - Circulation, 2011 - Am Heart Assoc
Circulation, 2011•Am Heart Assoc
The National Academy of Clinical Biochemistry issued a guideline in 2007 that stated that “in
the presence of a clinical history suggestive of ACS, the following is considered indicative of
myocardial necrosis consistent with myocardial infarction: maximal concentration of cTn
exceeding the 99th percentile of values (with optimal precision defined by total cv [coefficient
of variation] 10%) for a reference control group on at least one occasion during the first 24
hours after the clinical event.” 5 This guideline provides the framework for determining the …
the presence of a clinical history suggestive of ACS, the following is considered indicative of
myocardial necrosis consistent with myocardial infarction: maximal concentration of cTn
exceeding the 99th percentile of values (with optimal precision defined by total cv [coefficient
of variation] 10%) for a reference control group on at least one occasion during the first 24
hours after the clinical event.” 5 This guideline provides the framework for determining the …
The National Academy of Clinical Biochemistry issued a guideline in
2007 that stated that “in the presence of a clinical history suggestive of ACS, the following is considered indicative of myocardial necrosis consistent with myocardial infarction: maximal concentration of cTn exceeding the 99th percentile of values (with optimal precision defined by total cv [coefficient of variation] 10%) for a reference control group on at least one occasion during the first 24 hours after the clinical event.” 5 This guideline provides the framework for determining the decision limit or a “positive” troponin result.
Based on the 99th percentile rule, troponin decision limits of several high-sensitivity cTn assays can be set as low as 0.01 ng/mL. 6 This makes it possible to identify patients with ACS earlier, enabling earlier coronary intervention (Figure 2). However, while improving clinical sensitivity for the diagnosis of myocardial infarction, the
Am Heart Assoc