Clinician Preference for Troponin Monitoring

Abstract

Cardiovascular disease is on the rise in the United States and the cost of CVD is continuing to rise to an estimated at $800 billion by 2030. Serum troponin level is one lab value that is used in early detection and evaluation of cardiovascular disease. Research to date focuses on utilizing troponins as a diagnostic tool to evaluate morbidity and predict mortality. The implication for practice includes how the results of this project can be used in practice. There remains a gap in the literature regarding how serum troponins are utilized after a patient has developed myocardial injury. The purpose of this qualitative study is to evaluate the clinician’s preference of troponin monitoring after a myocardial infarction. The ACE Star Model of the Cycle of Knowledge Transformation was used as a guide in developing this project. A descriptive four question open-ended qualitative questionnaire was created to evaluate cardiac clinician preference on troponin monitoring. Ten out of 23 possible clinicians answered the questionnaire. The questionnaire showed a high level of agreement amongst clinicians as to the practices of trending troponins. All clinicians agreed that the high sensitivity troponin (hsTrop) should be utilized. In utilization of troponins as an advanced practice clinician, the recommendation is to trend troponins per hospital policy, but also to become familiar in recognizing how elevated troponins can change the plan of care. Further research on the subject of trending troponins after myocardial infarction is still needed.