title: High-sensitivity cardiac troponin assays: answers to frequently asked questions.
abstract: Cardiac troponin (cTn) assays have quickly gained in analytical sensitivity to become what are termed 'high-sensitivity cardiac troponin' (hs-cTn) assays, bringing a flurry of dense yet incomplete literature data. The net result is that cTn assays are not yet standardized and there are still no consensus-built data on how to use and interpret cTn assay results. To address these issues, the authors take cues and clues from multiple disciplines to bring responses to frequently asked questions. In brief, the effective use of hs-cTn hinges on knowing: specific assay characteristics, particularly precision at the 99th percentile of a reference population; factors of variation at the 99th percentile value; and the high-individuality of hs-cTn assays, for which the notion of individual kinetics is more informative than straight reference to 'normal' values. The significance of patterns of change between two assay measurements has not yet been documented for every hs-cTn assay. Clinicians need to work hand-in-hand with medical biologists to better understand how to use hs-cTn assays in routine practice.
authors: Laboratoire de Biochimie, GH Cochin-Broca-Hôtel Dieu, HUPC, Assistance Publique des Hôpitaux de Paris (AP-HP), 75014 Paris, France. Electronic address: camille.gobeaux@cch.aphp.fr.
authors: Camille
authors: C
authors: Chenevier-Gobeaux
authors: Service de Cardiologie, Hôpital Louis-Pradel, Hospices Civils de Lyon, 69002 Lyon, France.
authors: Éric
authors: É
authors: Bonnefoy-Cudraz
authors: Service d'Accueil des Urgences, Hôpital Rangueil, CHU de Toulouse, Université Toulouse III - Paul-Sabatier, INSERM UMR 1027 Équipe 5, 31400 Toulouse, France.
authors: Sandrine
authors: S
authors: Charpentier
authors: Laboratoire de Biochimie, Hôpital Bichat-Claude-Bernard, HUPNVS, Assistance Publique des Hôpitaux de Paris (AP-HP), 75018 Paris, France.
authors: Monique
authors: M
authors: Dehoux
authors: Laboratoire de Biochimie et Hormonologie, Hôpital Tenon, HUEP, Assistance Publique des Hôpitaux de Paris (AP-HP), 75020 Paris, France.
authors: Guillaume
authors: G
authors: Lefevre
authors: Service de Cardiologie, Hôpital Avicenne, HUPSSD, Assistance Publique des Hôpitaux de Paris (AP-HP), 93000 Bobigny, France; Université Paris 13, 93000 Paris, France.
authors: Christophe
authors: C
authors: Meune
authors: Service d'Accueil des Urgences, Hôpital Tenon, HUEP, Assistance Publique des Hôpitaux de Paris (AP-HP), 75020 Paris, France; Université Pierre-et-Marie-Curie, Paris 6, 75013 Paris, France; DHU 'Fighting against ageing and stress' (FAST), UPMC Paris 6, AP-HP, 75013 Paris, France.
authors: Patrick
authors: P
authors: Ray
mesh_terms: D015415:Biomarkers / Q000097:blood; D006801:Humans; D007118:Immunoassay / Q000592:standards; D009203:Myocardial Infarction / Q000175:diagnosis; D017202:Myocardial Ischemia / Q000175:diagnosis*; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity; D014336:Troponin / Q000032:analysis*; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; D014336:Troponin; D020107:Troponin T
keywords: Acute coronary syndrome; Chest pain; Douleur thoracique; Haute sensibilité; High-sensitivity; Infarctus du myocarde; Myocardial infarction; Syndrome coronarien aigu; Troponin; Troponine