BERLIN, May 18, 2011 /PRNewswire/ — Research presented this
week at the International Federation of Clinical Chemistry Congress
and Laboratory Medicine showed that using a lower diagnostic
threshold for troponin improves clinical outcomes and patient
survival in patients with suspected acute coronary syndromes.
Troponin is a protein found inside of heart cells that is
released when they are damaged by ischemia or reduced blood supply.
Cardiac troponin is regarded by clinicians as one of the most
specific biochemical markers for myocardial tissue injury, and the
latest generation of more sensitive assays can identify patients
with very small heart attacks. By improving the ability to
accurately triage patients presenting with chest pain, the use of
sensitive troponin assays could provide physicians with important
information to help reduce patient deaths.
The diagnostic threshold used during the validation phase was
0.20 ng/mL. During the implementation phase, the diagnostic
threshold was lowered to 0.05 ng/mL. The 2,092 patients with
suspected ACS who presented at the Royal Infirmary of Edinburgh
were stratified in three groups (troponin <0.05 ng/mL, 0.05 to
0.19 ng/mL, and greater than or equal to 0.20 ng/mL).
During the validation phase, 39 percent of patients with
troponin concentrations of 0.05 to 0.19 ng/mL died or were
readmitted with MI at one year. In contrast, only 21 percent
of patients with troponin concentrations of 0.05 to 0.19 died or
had a recurrent MI during the implementation phase. Lowering
the diagnostic threshold resulted in more referrals to specialists
and better treatment, explaining the improvement in clinical
outcomes in these patients.
Nicolas Mills, M.D., Ph.D., a cardiologist at the British Heart
Foundation Centre for Cardiovascular Science, and Simon Walker,
M.D., Ph.D., a senior lecturer and consultant in the Department of
Clinical Biochemistry a