Key result
Rapid diagnostic algorithms using high sensitivity troponin assays with 1-2 hour repeat sampling can predict with acceptable accuracy the diagnosis achieved with standard 6-12 hour sampling.
Why the study?
Do rapid diagnostic strategies using high sensitivity troponin assays with 1-2 hour repeat sampling provide acceptable diagnostic accuracy compared to standard 6-12 hour sampling?
Do rapid diagnostic strategies using high sensitivity troponin assays with 1-2 hour repeat sampling provide acceptable diagnostic accuracy compared to standard 6-12 hour sampling?
Rapid diagnostic algorithms using high-sensitivity troponin assays with 1-2 hour sampling intervals offer acceptable diagnostic accuracy compared to traditional 6-12 hour protocols.
Answers are grounded in this paper and cite their sources.
hs-cTn assays enable 1-2h rule-out algorithms; leaves open assay-specific cutoffs and broad implementation.
The introduction of high sensitivity measurement of cardiac troponin T (hs cTnT) and cardiac troponin I (hs cTnI) has given the laboratory the ability to measure very low levels of cardiac troponin. The limit of detection of these assays is well below the 99th percentile. These low levels can also be measured with small values of imprecision. A range of algorithms combining presentation measurement with repeat sample intervals of as little as one to 2 hours have been developed. These are able to predict with acceptable accuracy the diagnosis that would be achieved with continued repeat sampling out to six to 12 hours from presentation. In this article, we review the evidence for the diagnostic accuracy of these approaches and the practical aspects of implementation into routine clinical practice.
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Collinson et al. (2022) reported a review. Rapid diagnostic algorithms using high sensitivity cardiac troponin (hs cTnT and hs cTnI) vs. Continued repeat sampling out to 6 to 12 hours was evaluated on Diagnostic accuracy. Rapid diagnostic algorithms using high sensitivity troponin assays with 1-2 hour repeat sampling can predict with acceptable accuracy the diagnosis achieved with standard 6-12 hour sampling.
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