Analytical Issues Surrounding Troponin Assays

2007 Universal Definition of MI¹

October 2010

In 2007, a universal definition of MI was established to improve the accuracy of MI diagnosis. Key to this universal definition was the use of a highly sensitive and specific biomarker, troponin, determined from serial blood samples. It requires detection of a rise and/or fall of cardiac biomarkers with at least 1 of those concentrations being above the 99th percentile of the assay and evidence of myocardial ischemia (being symptoms, ECG changes, pathological Q waves, or imaging evidence). The timing of samples remains critical and serial testing is recommended for interpretation.

< Previous Slide

2007 Universal Definition of MI1

Next Slide >

 

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