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Using Extraordinary Optical Transmission to Quantify Cardiac Biomarkers in Human Serum
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Using Extraordinary Optical Transmission to Quantify Cardiac Biomarkers in Human Serum

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Lower Limits for Reporting High-Sensitivity Cardiac Troponin Assays and Impact of Analytical Performance on Patient

Kristin M Aakre1,2, Fred S Apple3,4, Nicolas L Mills5,6

  • 1Department of Medical Biochemistry and Pharmacology and Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.

Clinical Chemistry
|December 15, 2023
PubMed

Insights

Accurate cardiac troponin measurements are crucial for diagnosing heart attacks and predicting cardiovascular disease risk. Improving analytical quality at low concentrations is vital for patient care and accelerated diagnostic pathways.

Area of Science:

  • Clinical Chemistry
  • Biomarker Analysis
  • Cardiovascular Diagnostics

Background:

  • Cardiac troponin measurements are essential for diagnosing myocardial infarction and predicting cardiovascular disease risk.
  • Accelerated diagnostic pathways utilize low cardiac troponin concentrations, sometimes below the limit of quantification, raising concerns about analytical imprecision and patient misclassification.

Approach:

  • This mini-review by the IFCC C-CB examines the impact of reporting low cardiac troponin concentrations on assay classification and utility in accelerated diagnostic pathways.
  • It provides practical suggestions for laboratories on analytical quality assessment of cardiac troponin results at low cutoffs, focusing on accelerated diagnostic pathways.

Key Points:

  • Reporting low cardiac troponin concentrations affects assay classification as high-sensitivity.
  • Analytical performance at low concentrations is critical for the effectiveness of accelerated diagnostic pathways.
  • Future applications of cardiac troponins for risk prediction and management may necessitate enhanced analytical quality.

Conclusions:

  • Clinical guidelines advocate for using cardiac troponin concentrations near the limit of detection for patient care.
  • Laboratories, manufacturers, researchers, and EQA providers must extend analytical performance monitoring to include low concentration ranges relevant to accelerated diagnostic pathways.
Abstract

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