[Interpretation of mild elevation of high-sensitivity cardiac troponins].
Measurements of cardiac troponins (cTn) are yet considered the gold standard method in patients with chest pain. Very recently, high-sensitivity (hs)cTn emerged and allow to measure very low concentrations of cTn. The aim of these assays was the better detection of patients with acute myocardial infarction (AMI). The threshold value should be the 99th percentile of the method, which corresponds to the concentration obtained from 99% of a reference population. These assays improve the detection of patients with elevated cTn concentrations. All patients with increased hs-cTn concentration above the 99th percentile should be considered at high risk of future clinical event when compared to patients with lower concentration. However, these elevated concentrations are not necessarily related to AMI due to coronary artery plaque rupture and superimposed thrombus. In order to understand adequately cTn measurement, the physician should base his interpretation on the context, the cTn concentration, variations during serial sampling, and the possible existence of a coexistent disease characterized by increased cTn concentrations.
Service de cardiologie, Université Paris 13, Université Paris Descartes, Hôpital Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), Bobigny, France.
Christophe
C
Meune
François-Xavier
FX
Goudot
Linda
L
Aïssou
Camille
C
Chenevier-Gobeaux
D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis; D003627:Data Interpretation, Statistical; D003935:Diagnostic Techniques, Cardiovascular / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007118:Immunoassay / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D009206:Myocardium / Q000378:metabolism; D012016:Reference Values; D012680:Sensitivity and Specificity; D014336:Troponin / Q000097:blood* / Q000378:metabolism; D015854:Up-Regulation
D014336:Troponin
acute myocardial infarction; biomarker; cardiac troponin; high-sensitivity immunoassay