Analytical Issues Surrounding Troponin Assays

Current Mayo Cardiac Biomarker Panel

October 2010

At Mayo, our current cardiac biomarker panel uses the Roche 4th generation troponin T assay. It is performed in the Hospital Clinical Laboratory on the Roche e411 using plasma samples and in the Central Clinical Laboratory on the Roche Modular E170 using serum. When ordered, a baseline sample is drawn and subsequent samples are drawn 3 and 6 hours later. The normal range is defined as < or =0.01 ng/mL and anything above that is flagged as abnormal. CK-MB was removed from the biomarker panel a few years ago.

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Current Mayo Cardiac Biomarker Panel

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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