High-sensitivity troponin measurements: challenges and opportunities for the laboratory and the clinician

Troponin, delta change and the evolution of cardiac biomarkers – back to the future (again)

“…30 Improvement in assay sensitivity also suggests that the use of additional markers such as heart fatty acid binding protein and co-peptin 31 used to improve sensitivity in the early period following MI may not be required. 32 The advent of high-sensitivity assays capable of measuring low concentrations of troponin with good precision has resulted in evaluation of a range of strategies for rapid diagnosis 33 including single measurement on admission 34,35 and short interval serial (1-2 h) measurement strategies. 36,37 Such strategies may be difficult to realize in routine clinical practice and short sampling intervals using low level cut-offs, the 99th percentile and a delta value may be more appropriate.…”