115 - High sensitive methods for cardiac troponin assay: analytical characteristics and pathophysiological aspects
Autor(s): A. Clerico, C. Prontera
Issue: RIMeL - IJLaM, Vol. 4, N. 3-S1, 2008 (MAF Servizi srl ed.)
Page(s): 115
TIn 2000, the European Society of Cardiology/American College of Cardiology (ESC/ACC) consensus conference along with the American Heart Association (AHA)/ ACC guidelines for differentiating acute myocardial infarction (AMI) and unstable angina codified the role of cardiac troponin monitoring by advocating that (a) diagnosis of AMI and (b) risk stratification are based on the increase in cardiac troponin I (cTnI) or T (cTnT), in an appropriate clinical setting; in 2007, these recommendations were confirmed by the so-called “Universal Definition of Myocardial Infarction”. Moreover, in 2001 the IFCC C-SMCD established recommended quality specifications for cardiac troponin assay. In particular, these guidelines recommend that an increased concentration of cardiac troponin should be defined as a measurement exceeding the 99th percentile of the distribution of cardiac troponin concentrations in the reference group. A total imprecision (CV) at this decision limit of 10% is recommended. Unfortunately, at present time, analytical imprecision is not uniform among different commercial immunoassays for cardiac troponins, mainly within the low concentration range, and therefore some troponin assays do not fit the goals recommended for functional sensitivity. As a result, a new generation of more sensitive and standardized cTnI immunoassays should show a ratio of 10% CV concentration ... TIn 2000, the European Society of Cardiology/American College of Cardiology (ESC/ACC) consensus conference along with the American Heart Association (AHA)/ ACC guidelines for differentiating acute myocardial infarction (AMI) and unstable angina codified the role of cardiac troponin monitoring by advocating that (a) diagnosis of AMI and (b) risk stratification are based on the increase in cardiac troponin I (cTnI) or T (cTnT), in an appropriate clinical setting; in 2007, these recommendations were confirmed by the so-called “Universal Definition of Myocardial Infarction”. Moreover, in 2001 the IFCC C-SMCD established recommended quality specifications for cardiac troponin assay. In particular, these guidelines recommend that an increased concentration of cardiac troponin should be defined as a measurement exceeding the 99th percentile of the distribution of cardiac troponin concentrations in the reference group. A total imprecision (CV) at this decision limit of 10% is recommended. Unfortunately, at present time, analytical imprecision is not uniform among different commercial immunoassays for cardiac troponins, mainly within the low concentration range, and therefore some troponin assays do not fit the goals recommended for functional sensitivity. As a result, a new generation of more sensitive and standardized cTnI immunoassays should show a ratio of 10% CV concentration ...