open access

Vol 78, No 11 (2020)
Review paper
Published online: 2020-08-25
Get Citation

Use of cardiac troponin in the early diagnosis of acute myocardial infarction

Piotr Muzyk, Raphael Twerenbold, Beata Morawiec, Pedro Lopez Ayala, Jasper Boeddinghaus, Thomas Nestelberger, Christian Mueller, Damian Kawecki
DOI: 10.33963/KP.15585
·
Pubmed: 32847343
·
Kardiol Pol 2020;78(11):1099-1106.

open access

Vol 78, No 11 (2020)
Review article
Published online: 2020-08-25

Abstract

The diagnosis ofcoronary artery disease, which is one of the most common causes of death and disability worldwide, still remains a significant problem for clinicians. High‑sensitivity cardiac troponin (hs‑cTn) assays became the cornerstone in the diagnostic workup of acute myocardial infarction. Nowadays, they take an important position in diagnostic algorithms. However, there are still some unexplained issues in this field.This review summarizes and emphasizes the crucial role of hs‑cTn in acute coronary syndromes. The 0/1‑hour hs‑cTn algorithm was mentioned for the first time in the 2015 official European Society of Cardiology guidelines on non–ST‑segment‑elevation acute coronary syndromes. It was derived, validated, and implemented for all clinically‑available assays since then. In this review, troponin‑based strategies for rapid rule‑out or rule‑in of non–ST‑segment elevation myocardial infarction are gathered and compared with the update on the official European Society of Cardiology 0/1‑hour pathway with the most recent values of hs‑cTn. The document also focuses on the problem of possible analytic confounders (false‑‑positive and false‑negative results) and compares the usefulness of cTn to other diagnostic techniques (eg, magnetic resonance imaging). The review is divided into short, easy‑to‑read sections emphasizing 6 key messages on how to use and interpret hs‑cTn base algorithms in clinical practice at the emergency department.

Abstract

The diagnosis ofcoronary artery disease, which is one of the most common causes of death and disability worldwide, still remains a significant problem for clinicians. High‑sensitivity cardiac troponin (hs‑cTn) assays became the cornerstone in the diagnostic workup of acute myocardial infarction. Nowadays, they take an important position in diagnostic algorithms. However, there are still some unexplained issues in this field.This review summarizes and emphasizes the crucial role of hs‑cTn in acute coronary syndromes. The 0/1‑hour hs‑cTn algorithm was mentioned for the first time in the 2015 official European Society of Cardiology guidelines on non–ST‑segment‑elevation acute coronary syndromes. It was derived, validated, and implemented for all clinically‑available assays since then. In this review, troponin‑based strategies for rapid rule‑out or rule‑in of non–ST‑segment elevation myocardial infarction are gathered and compared with the update on the official European Society of Cardiology 0/1‑hour pathway with the most recent values of hs‑cTn. The document also focuses on the problem of possible analytic confounders (false‑‑positive and false‑negative results) and compares the usefulness of cTn to other diagnostic techniques (eg, magnetic resonance imaging). The review is divided into short, easy‑to‑read sections emphasizing 6 key messages on how to use and interpret hs‑cTn base algorithms in clinical practice at the emergency department.

Get Citation
About this article
Title

Use of cardiac troponin in the early diagnosis of acute myocardial infarction

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 78, No 11 (2020)

Article type

Review paper

Pages

1099-1106

Published online

2020-08-25

Page views

559

Article views/downloads

642

DOI

10.33963/KP.15585

Pubmed

32847343

Bibliographic record

Kardiol Pol 2020;78(11):1099-1106.

Authors

Piotr Muzyk
Raphael Twerenbold
Beata Morawiec
Pedro Lopez Ayala
Jasper Boeddinghaus
Thomas Nestelberger
Christian Mueller
Damian Kawecki

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Sp. z o.o. VM Group Sp.k., ul. Świętokrzyska 73 , 80–180 Gdańsk, Poland

phone:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl