High-sensitivity cardiac troponin assays: what analytical and clinical issues need to be addressed before introduction into clinical practice? Interview by Fred S. Apple.

摘要

The guidelines of the Global Task Force for the Universal Definition of Myocardial Infarction (MI)2 and the complementary laboratory medicine practice guidelines of the National Academy of Clinical Biochemistry (NACB), both published in 2007, established cardiac troporiin (cTn) as the standard biomarker for the diagnosis of MI. Ongoing improvements in technology over the past several years have advanced the analytical detection of low concentrations of cTn (I and T) in blood, serum, and plasma. "Contemporary" assays demonstrate excellent diagnostic accuracy for detection of MI by using the recommended 99th percentile concentration as the medical decision cutoff value in specimens obtained at presentation. Optimal accuracy is seen with these assays in samples obtained 6 or more hours after presentation.