What Lab Professionals Must Know About High-Sensitivity Troponin Assay Performance
High-sensitivity cardiac troponin assays have transformed acute MI diagnosis but introduce new analytical challenges at low concentrations. This review details the pre-analytical, analytical, and post-analytical requirements that laboratorians must scrutinise to ensure robust clinical reporting. Understanding assay-specific performance characteristics is essential for avoiding misinterpretation in everyday practice.
The original study
Laboratory-related issues in the measurement of cardiac troponins with highly sensitive assays.
- Authors
- Krintus M, Panteghini M
- Journal
- Clinical chemistry and laboratory medicine
- Type
- Journal Article, Review
- PMID
- 32134723
Original abstract
A number of assay-related issues can affect the performance of cardiac troponin (cTn) measurement in everyday practice. In this respect, it is vital that all information on cTn assays is known and that the performance characteristics of assays are objectively assessed and adequately described. The advent of the latest generation of more sensitive cTn assays has heralded a new wave of information about low concentrations of cTn in blood. These recent generation assays have improved analytical sensitivity and corresponding performance at low cTn concentrations when compared to their predecessors, providing a convincing goal for laboratory medicine in helping clinicians in the diagnosis of acute myocardial infarction. Crucial to the clinical utility of highly sensitive cTn assays is the laboratorians' role in closely scrutinizing proposed assays and defining their value in relation to available evidence. Analytical, as well as pre-analytical and post-analytical, aspects must be documented. In this review, we describe what laboratory professionals should know about their cTn assay performance characteristics and the pre-analytical prerequisites for robustness to ensure optimal post-analytical reporting.