High sensitive troponin-I

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What is ACS?

It stands for Acute coronary syndrome (ACS) which is a general term for a range of conditions that occur when there is a sudden reduction of blood flow to the heart, such as ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI).1

Challenges

The global burden of ACS

It is estimated, more than 7 Million people are diagnosed with ACS each year.2

30% of patients do not experience any chest pain3 which can contribute to erroneously discharging patients.4

Rapidly diagnosing and triaging chest pain patients

Emergency departments worldwide continually face the challenge of rapidly diagnosing and triaging chest pain patients.

Patient test results can help clarify the clinical picture. Timely action on cardiac laboratory results is critical and may improve patient outcomes.

The laboratory can help address some challenges by offering cardiac tests that are accurate, reliable and fast.

The enhanced sensitivity and precision of high sensitivity troponin assays combined with sex-specific cut-offs, allow for faster and more accurate assessment of suspected myocardial infarction,7 particularly in women, who tend to have lower circulating levels of troponin, even when having an MI. 5

The value of troponin

Alinity and ARCHITECT High Sensitive Troponin-I results may enable easier management of patients with suspect
Acute Myocardial Infarction (AMI) through:

Excellent precision and high sensitivity

This assay complies with the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) requisites for high sensitive troponin analytical characteristics, including low end detection in a normal healthy population and imprecision of less than 6% CV at the medical decision points, which help to provide accurate and reliable results for ACS evaluation.

Establishing accurate cutoff values in males and females

The use of sex-specific cutoffs enables more tailored healthcare and facilitates effective and efficient identification of those with clinically significant increases in their circulating troponin-I levels. When sex-specific cut-offs are not employed, women are potentially 6-times more likely to experience a recurrent MI or cardiovascular death.5

Improved emergency department throughput

A "true" high sensitive assay for cardiac troponin I allows a reduction in the testing interval of patients admitted for suspect AMI from 6 hours to 3 hours or even down to 1 hour, as advocated by the most recent European Society of Cardiology (ESC) guidelines.6

Improved lab operational advantages

Abbott instruments help to increase operational productivity and consistently provide high quality services, managing increased work volumes and operating with fewer trained personnel.

Additional use cases for High Sensitive Troponin7,8

Diagnosis

As an aid in the diagnosis of myocardial infarction. 

Assessment

To aid in the assessment of 30-day and 90-day prognosis relative to all-cause mortality and major adverse cardiac events consisting of MI, revascularisation and cardiac death in patients who present with symptoms suggestive of ACS.

Categorizing Risk

In conjunction with clinical and diagnostic findings, it aids in categorizing asymptomatic individuals at risk of cardiovascular disease, including cardiovascular death, myocardial infarction, coronary revascularisation, heart failure or ischemic stroke. 

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References
  1. National Institute For Health And Care Excellence. 2014.
  2. Bhatt DL et al. JAMA. 2022;327(7):662-675.
  3. DeVon HA et al. J Am Heart Assoc. 2020;9(7):e015539.
  4. Haider et al. Eur Heart J. 2020;41(13):1328–1336.
  5. Shah ASV, Griffiths M, Lee KK, et al. High sensitivity cardiac troponin and the under-diagnosis of myocardial infarction in women: prospective cohort study. BMJ. 2015; 350: g7873.
  6. Reichlin T, et al., 2012.
  7. Alinity i STAT High Sensitive Troponin-I Package Insert H05938R04.
  8. ARCHITECT STAT High Sensitive Troponin-I [package insert]. Lake Bluff, IL: Abbott Laboratories; G97079R02. September 2021.