title: Recommendations for the use of cardiac troponin measurement in acute cardiac care.
abstract: The release of cardiomyocyte components, i.e. biomarkers, into the bloodstream in higher than usual quantities indicates an ongoing pathological process. Thus, detection of elevated concentrations of cardiac biomarkers in blood is a sign of cardiac injury which could be due to supply-demand imbalance, toxic effects, or haemodynamic stress. It is up to the clinician to determine the most probable aetiology, the proper therapeutic measures, and the subsequent risk implied by the process. For this reason, the measurement of biomarkers always must be applied in relation to the clinical context and never in isolation. There are a large number of cardiac biomarkers, but they can be subdivided into four broad categories, those related to necrosis, inflammation, haemodynamic stress, and/or thrombosis. Their usefulness is dependent on the accuracy and reproducibility of the measurements, the discriminatory limits separating pathology from physiology, and their sensitivity and specificity for specific organ damage and/or disease processes. In recent years, cardiac biomarkers have become important adjuncts to the delivery of acute cardiac care. Therefore, the Working Group on Acute Cardiac Care of the European Society of Cardiology established a committee to deal with ongoing and newly developing issues related to cardiac biomarkers. The intention of the group is to outline the principles for the application of various biomarkers by clinicians in the setting of acute cardiac care in a series of expert consensus documents. The first of these will focus on cardiac troponin, a pivotal marker of cardiac injury/necrosis.
authors.affiliation: Department of Medicine and Cardiology, Aarhus University Hospital, Tage-Hansens Gade 2, DK-8000 Aarhus C, Denmark. kristhyg@rm.dk
authors.forename: Kristian
authors.initials: K
authors.lastname: Thygesen
authors.forename: Johannes
authors.initials: J
authors.lastname: Mair
authors.forename: Hugo
authors.initials: H
authors.lastname: Katus
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.forename: Per
authors.initials: P
authors.lastname: Venge
authors.forename: Paul
authors.initials: P
authors.lastname: Collinson
authors.forename: Bertil
authors.initials: B
authors.lastname: Lindahl
authors.forename: Evangelos
authors.initials: E
authors.lastname: Giannitsis
authors.forename: Yonathan
authors.initials: Y
authors.lastname: Hasin
authors.forename: Marcello
authors.initials: M
authors.lastname: Galvani
authors.forename: Marco
authors.initials: M
authors.lastname: Tubaro
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Alpert
authors.forename: Luigi M
authors.initials: LM
authors.lastname: Biasucci
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koenig
authors.forename: Christian
authors.initials: C
authors.lastname: Mueller
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.forename: Christian
authors.initials: C
authors.lastname: Hamm
authors.forename: Allan S
authors.initials: AS
authors.lastname: Jaffe
mesh_terms: D001681:Biological Assay / Q000592:standards; D015415:Biomarkers / Q000097:blood; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis*; D012016:Reference Values; D012680:Sensitivity and Specificity; D014336:Troponin / Q000097:blood*
chemical_list: D015415:Biomarkers; D014336:Troponin