Low concentrations of high-sensitivity troponin T at presentation to the emergency department (Letter)
Author(s)
Carlton, E
Kendall, J
Khattab, A
Greaves, K
Griffith University Author(s)
Year published
2017
Metadata
Show full item recordAbstract
To the Editor: Several issues around rule-out strategies utilizing low concentrations of high-sensitivity cardiac troponin assays taken at presentation to the Emergency Department (ED)1 remain unexplored. First, large-scale analyses investigating cutoff concentrations for high-sensitivity cardiac troponin I (hs-cTnI; Abbott Architect) <99th percentile, have failed to investigate outcomes that incorporate the full spectrum of clinically relevant acute coronary syndromes, namely emergency revascularization (1, 2). Second, whether these strategies work with the high-sensitivity cardiac troponin T (hs-cTnT; Roche Elecsys) assay ...
View more >To the Editor: Several issues around rule-out strategies utilizing low concentrations of high-sensitivity cardiac troponin assays taken at presentation to the Emergency Department (ED)1 remain unexplored. First, large-scale analyses investigating cutoff concentrations for high-sensitivity cardiac troponin I (hs-cTnI; Abbott Architect) <99th percentile, have failed to investigate outcomes that incorporate the full spectrum of clinically relevant acute coronary syndromes, namely emergency revascularization (1, 2). Second, whether these strategies work with the high-sensitivity cardiac troponin T (hs-cTnT; Roche Elecsys) assay is underexplored. Finally, the impact of laboratory rounding (i.e., rounding the reported value up or down to the next whole integer depending on the exact post–decimal point value—e.g., 4.5 ng/L to 5 ng/L) upon diagnostic performance at low cutoff concentrations, and how this effects the proportion of patients potentially eligible for early discharge, remains unknown.
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View more >To the Editor: Several issues around rule-out strategies utilizing low concentrations of high-sensitivity cardiac troponin assays taken at presentation to the Emergency Department (ED)1 remain unexplored. First, large-scale analyses investigating cutoff concentrations for high-sensitivity cardiac troponin I (hs-cTnI; Abbott Architect) <99th percentile, have failed to investigate outcomes that incorporate the full spectrum of clinically relevant acute coronary syndromes, namely emergency revascularization (1, 2). Second, whether these strategies work with the high-sensitivity cardiac troponin T (hs-cTnT; Roche Elecsys) assay is underexplored. Finally, the impact of laboratory rounding (i.e., rounding the reported value up or down to the next whole integer depending on the exact post–decimal point value—e.g., 4.5 ng/L to 5 ng/L) upon diagnostic performance at low cutoff concentrations, and how this effects the proportion of patients potentially eligible for early discharge, remains unknown.
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Journal Title
Clinical Chemistry
Volume
63
Issue
1
Subject
Medical biotechnology
Medical biochemistry and metabolomics
Clinical sciences