Clin Exp Emerg Med.  2016 Mar;3(1):1-8. 10.15441/ceem.16.120.

Troponin assay use in the emergency department for management of patients with potential acute coronary syndrome: current use and future directions

• Fox WR
• Diercks DB

• KMID: 2360967
• DOI: http://doi.org/10.15441/ceem.16.120

Abstract

Troponins are proteins commonly found in cardiac tissue that are released during myocardial ischemia or necrosis. These troponins can be detected by assays that can then be used to guide clinical decision-making and disposition, especially if the suspected insult is related to acute coronary syndrome. Timing of troponin measurement can be important as elevations may not be detectible immediately after an insult. New assays have been designed to detect troponin con-centrations previously too low to be detected by conventional assays. These tests are known as high-sensitivity cardiac troponin assays. Current research is aimed at evaluating the clinical sig-nificance of troponin elevations detected by these new assays especially in management of pa-tients with suspected acute coronary syndrome. A number of risk-stratification scores exist to assist physicians with evaluating chest pain in the emergency department in the context of de-tection (or absence) of troponins in systemic circulation. Additionally, investigators are working to integrate data generated by hs-cTn measurements into existing and new risk-stratification scores.

Keyword

Myocardial infarction; Troponin; Risk stratification; Diagnostic test; Prognosis

MeSH Terms

Acute Coronary Syndrome*
Chest Pain
Clinical Decision-Making
Diagnostic Tests, Routine
Emergencies*
Emergency Service, Hospital*
Humans
Myocardial Infarction
Myocardial Ischemia
Necrosis
Prognosis
Research Personnel
Troponin*
Troponin