期刊
CLINICAL CHEMISTRY
卷 68, 期 8, 页码 1022-1030出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/clinchem/hvac092
关键词
cardiac troponin; high-sensitivity cardiac troponin; 99th percentile; chest pain; diagnosis; myocardial infarction; myocardial injury; prognosis; nonischemic cardiovascular disease; normality; reference interval
资金
- Siemens Healthineers
- Abbott Point of Care
- National Institute of Health Research
- Asthma UK
- British Lung Foundation
- UK Department of Health
- Social Care and service from My110
- Randox
- Avacta
- LumiraDx
- Chronomics
- iXensor
- BD
- Horiba
- Abbott
- Beckman
- Ortho
- Roche
- Siemens
- Hennepin Healthcare Research Institute: Abbott Diagnostics
- Abbott POC
The International Federation of Clinical Chemistry Committee on Clinical Application of Cardiac Bio-Markers provides educational documents to promote uniform interpretation and utilization of cardiac biomarkers. The measurement of high-sensitivity cardiac troponin plays a crucial role in evaluating patients with symptoms and/or signs of acute cardiac ischemia.
The International Federation of Clinical Chemistry Committee on Clinical Application of Cardiac Bio-Markers provides evidence-based educational documents to facilitate uniform interpretation and utilization of cardiac biomarkers in clinical laboratories and practice. The committee's goals are to improve the understanding of certain key analytical and clinical aspects of cardiac biomarkers and how these may interplay in clinical practice. Measurement of high-sensitivity cardiac troponin (hs-cTn) assays is a cornerstone in the clinical evaluation of patients with symptoms and/or signs of acute cardiac ischemia. To define myocardial infarction, the Universal Definition of Myocardial Infarction requires patients who manifest with features suggestive of acute myocardial ischemia to have at least one cTn concentration above the sex-specific 99th percentile upper reference limit (URL) for hs-cTn assays and a dynamic pattern of cTn concentrations to fulfill the diagnostic criteria for MI. This special report provides an overview of how hs-cTn 99th percentile URLs should be established, including recommendations about prescreening and the number of individuals required in the reference cohort, how statistical analysis should be conducted, optimal preanalytical and analytical protocols, and analytical/biological interferences or confounds that can affect accurate determination of the 99th percentile URLs. This document also provides guidance and solutions to many of the issues posed.
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