Key result
Troponin use reaches ~93% for diagnosing myocardial infarction across Nordic hospitals despite variable cut-offs.
Cross-Sectional (n=167)
Yes
Nordic hospitals have largely adopted troponin testing for MI diagnosis in accordance with ESC/ACC guidelines, though harmonization of assay cut-offs is still needed.
OBJECTIVES: To investigate the diagnostic approach in Nordic hospitals receiving patients suspected of acute myocardial infarction (MI), especially focusing on implementation of the recently proposed criteria by the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) for the definition of MI. DESIGN: A survey with questionnaires of the diagnostic approach was conducted among all relevant departments (220) in the Nordic countries. RESULTS: Seventy-six percent (167) of hospitals responded. Troponins I and T (TnI and TnT) and creatinine kinase monobasic fraction (mass concentration) (CKMB(mass)) covered 93 and 65% of hospitals, respectively. Of troponin users, 34% indicated use of TnI vs 66% using TnT. Sporadic use of AST, CK, LD and myoglobin was reported. There was a tendency to lower cut-off levels in Sweden and Finland. Among troponin assays, there was considerable heterogeneity regarding cut-off levels. CONCLUSIONS: The Nordic countries are approaching ESC/ACC consensus on cardiac markers. Compared with previous national surveys (1995-1999), there is a shift towards the use of troponins. However, differences in cut-off levels of troponin emphasize the need for harmonization of assays.
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Hjortshøj et al. (2005) conducted a cross-sectional in Acute Myocardial Infarction (n=167). Diagnostic approach for myocardial infarction (cardiac markers) was evaluated on Proportion of hospitals using Troponins (I and T) for biochemical diagnosis. In a survey of 167 Nordic hospitals, 93% reported using troponins for diagnosing acute myocardial infarction, highlighting a shift toward ESC/ACC consensus despite considerable heterogeneity in assay cut-off levels.
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