title: Preparing the United States for high-sensitivity cardiac troponin assays.
abstract: It is only a matter of time before the use of high-sensitivity cardiac troponin assays (hs-cTn) becomes common throughout the United States. In preparation for this inevitability, this article raises a number of important issues regarding these assays that deserve consideration. These include: the need for the adoption of a universal nomenclature; the importance of defining uniform criteria for reference populations; the challenge of discriminating between acute and nonacute causes of hs-cTn elevations, and between type 1 and type 2 acute myocardial infarction (AMI); factors influencing the analytical precision of hs-cTn; ascertaining the optimal duration of the rule-out period for AMI; the need for further evaluation to determine the causes of a positive hs-cTn in non-AMI patients; and the use of hs-cTn to risk-stratify patients with disease conditions other than AMI. This review elaborates on these critical issues as a means of educating clinicians and researchers about them.
authors: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors: Frederick K
authors: FK
authors: Korley
authors: Allan S
authors: AS
authors: Jaffe
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D003937:Diagnosis, Differential; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D018579:Patient Selection; D012680:Sensitivity and Specificity; D009626:Terminology as Topic; D014336:Troponin / Q000097:blood*; D014481:United States
chemical_list: D015415:Biomarkers; D014336:Troponin