Cardiac troponin testing in the acute care setting: ordering, reporting, and high sensitivity assays--an update from the Canadian society of clinical chemists (CSCC).

摘要

Since 2007, when the Universal Definition of Myocardial Infarction (MI) was published [1 ], several studies have described the use of both sensitive and high sensitivity (hs) cardiac troponin (cTn) assays in the emergency setting [2-4], and others have detailed the diagnostic and prognostic performance of these hs-cTn assays in and outside of the acute care setting [5-13]. With the rapidly evolving information on the utility of cTn, especially with regard to the hs-cTn assays [14], as well as the uncertainty about when the next set of guidelines from expert groups will be published (possibly in 2012 or early 2013), a working group of the Canadian Society of Clinical Chemists (CSCC) met at the Canadian Laboratory Medicine Congress in Vancouver in 2011 to discuss recent data; and this group obtained additional input from both CSCC members and various clinical specialists. Below is a summary of key discussion points that may be useful for laboratory professionals when engaging their clinical colleagues in adopting an evidence-based approach for using sensitive and the high sensitivity cTn assays in an acute care setting.