High-sensitivity Troponin-T: Difference between revisions
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== Cutoffs == | |||
Hs-cTnT is considered "positive" when above the gender-specific 99th percentile URL (upper reference range). Per eMail from Scott Cox (YKDHR Director of Diagnostic Services) on 11/10/2019, the following cutoff are recommended for our assay: | |||
{| class="wikitable" style="margin: auto;" | |||
|+Positive Values | |||
|- | |||
| Women || >= '''14''' ng/L | |||
|- | |||
| Men || >= '''22''' ng/L | |||
|} | |||
<br> | |||
A delta (i.e. change of over time) >= '''3''' ng/L is considered positive for acute myocardial injury (AMI).<br> | |||
<br> | |||
The ACC white paper (see below) recommends:<br> | |||
* A single Hs-cTnT >= '''100''' ng/L is diagnostic of AMI (in the appropriate clinical context).<br> | |||
* When chest pain has been present for >= 2 hours, a single Hs-cTnT < '''6''' ng/L can rule out AMI with essentially 100% negative predictive value. | |||
<br> | |||
== Helpful Links == | == Helpful Links == | ||
'''American College of Cardiology''' | '''American College of Cardiology''' | ||
Revision as of 10:49, 2 December 2019
The U.S. FDA approved the first high-sensitivity troponin assay, the Roche Diagnostics Elecsys Troponin T (TnT) Gen 5 Stat test, in March 2017.
Yukon-Kuskokwim Delta Regional Hospital (YKDHR) adopted this high-sensitivity cardiac troponin-T (Hs-cTnT) assay on November 12, 2019.
The high-sensitivity and contemporary troponin-T assays can be distinguished by the units in which they are reported: Hs-cTnT is reported in ng/L whereas the contemporary assay (cTnT) is reported in ng/mL.
Cutoffs
Hs-cTnT is considered "positive" when above the gender-specific 99th percentile URL (upper reference range). Per eMail from Scott Cox (YKDHR Director of Diagnostic Services) on 11/10/2019, the following cutoff are recommended for our assay:
| Women | >= 14 ng/L |
| Men | >= 22 ng/L |
A delta (i.e. change of over time) >= 3 ng/L is considered positive for acute myocardial injury (AMI).
The ACC white paper (see below) recommends:
- A single Hs-cTnT >= 100 ng/L is diagnostic of AMI (in the appropriate clinical context).
- When chest pain has been present for >= 2 hours, a single Hs-cTnT < 6 ng/L can rule out AMI with essentially 100% negative predictive value.
Helpful Links
American College of Cardiology
- High-Sensitivity Cardiac Troponin in the Evaluation of Possible AMI (July 16, 2018)
- SUMMARY: Fourth Universal Definition of Myocardial Infarction (Aug 25, 2018)
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