Analytical Issues Surrounding Troponin Assays

Recommendations for Point-of-Care Cardiac Marker Testing^2,3

October 2010

Point-of-care cardiac marker testing is also an area that is commonly debated. The National Academy of Clinical Biochemistry guidelines recommend the turnaround time for troponin should be less than 1 hour over 90% of the time. Ideally, the turnaround time would be less than 30 minutes and timing is defined from collection to reporting. If point of care testing is used the results should be quantitative and the analytical characteristics of the POC test should be identical to the central lab’s troponin assay. Currently there are no POC methods that have acceptable analytical sensitivity and it is often argued that the turnaround time is essentially sacrificed for a lower quality result.

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Recommendations for Point-of-Care Testing

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Jump to section:

• Introduction
• Challenges in Cardiovascular Medicine
• Shades of Gray
• Cardiac Markers
• Troponin Elevations are Greater and Persist Over Longer Time Periods
• 2007 Universal Definition of MI1
• Serial Sampling
• Elevation of cTn in Patients Without Overt Ischemic Heart Disease¹
• Analytic Confusion: Sensitivity and Imprecision of cTn Assays
• Analytical Definitions (Related to Troponin)
• Current Troponin Assays
• Defining the 99th Percentile (Normal Population)
• Troponin T or Troponin I: Does it Matter?
• Is CK-MB Needed Anymore?
• Recommendations for Point-of-Care Cardiac Marker Testing^2,3
• Does POCT Make Any Difference?
• What About the High-Sensitive Troponin Assays?
• Why All the Hype for High-Sensitivity Troponin?
• Troponin Concentrations and Diagnostic Accuracy⁴
• How Sensitive Does Troponin Testing Really Need to Be?
• Current Mayo Cardiac Biomarker Panel
• Current Mayo Cardiac Biomarker Panel
• Conclusions
• References
• Questions?
• Disclosure