Single Troponin Measurement to Rule Out Myocardial Infarction: JACC Review Topic of the Week

The term “single-sample rule-out” refers to the ability of very low concentrations of high-sensitivity cardiac troponin (hs-cTn) on presentation to exclude acute myocardial infarction with high clinical sensitivity and negative predictive value. Observational and randomized studies have confirmed this ability. Some guidelines endorse use of a concentration of hs-cTn at the assay's limit of detection, while other studies have validated the use of higher concentrations, allowing this approach to identify a greater proportion of patients at low risk. In most studies, at least 30% of patients can be triaged with this approach. The concentration of hs-cTn varies according to the assay used and sometimes how regulations permit reporting. It is clear that patients need to be at least 2 hours from the onset of symptoms being evaluated. Caution is warranted, particularly with older patients, women, and patients with underlying cardiac comorbidities.

Body, Richard (author)
Mills, Nicholas L. (author)
Aakre, Kristin M. (author)
Collinson, Paul O. (author)
Saenger, Amy (author)
Hammarsten, OlaGothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för laboratoriemedicin,Department of Laboratory Medicine(Swepub:gu)xhamol (author)
Wereski, Ryan (author)
Omland, Torbjørn (author)
Sandoval, Yader (author)
Ordonez-Llanos, Jordi (author)
Apple, Fred S. (author)
Göteborgs universitetInstitutionen för biomedicin, avdelningen för laboratoriemedicin (creator_code:org_t)

In:Journal of the American College of Cardiology82:1, s. 60-690735-10971558-3597

By the author/editor: Jaffe, Allan S.; Body, Richard; Mills, Nicholas ...; Aakre, Kristin M ...; Collinson, Paul ...; Saenger, Amy; show more...; Hammarsten, Ola; Wereski, Ryan; Omland, Torbjørn; Sandoval, Yader; Ordonez-Llanos, ...; Apple, Fred S.; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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