Loading…
Clinical Interpretation of Serum Troponin in the Era of High-Sensitivity Testing
Cardiac troponin (Tn) plays a central role in the evaluation of patients with angina presenting with acute coronary syndrome. The advent of high-sensitivity assays has improved the analytic sensitivity and precision of serum Tn measurement, but this advancement has come at the cost of poorer specifi...
Saved in:
Published in: | Diagnostics (Basel) 2024-02, Vol.14 (5), p.503 |
---|---|
Main Authors: | , , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | |
---|---|
cites | cdi_FETCH-LOGICAL-c517t-392f6b416a35305695512aaeeb3c069d1b0d1026594bae2a1957a10e157c36fe3 |
container_end_page | |
container_issue | 5 |
container_start_page | 503 |
container_title | Diagnostics (Basel) |
container_volume | 14 |
creator | Maayah, Marah Grubman, Scott Allen, Stephanie Ye, Zachary Park, Dae Yong Vemmou, Evangelia Gokhan, Ilhan Sun, Wendy W Possick, Stephen Kwan, Jennifer M Gandhi, Parul U Hu, Jiun-Ruey |
description | Cardiac troponin (Tn) plays a central role in the evaluation of patients with angina presenting with acute coronary syndrome. The advent of high-sensitivity assays has improved the analytic sensitivity and precision of serum Tn measurement, but this advancement has come at the cost of poorer specificity. The role of clinical judgment is of heightened importance because, more so than ever, the interpretation of serum Tn elevation hinges on the careful integration of findings from electrocardiographic, echocardiographic, physical exam, interview, and other imaging and laboratory data to formulate a weighted differential diagnosis. A thorough understanding of the epidemiology, mechanisms, and prognostic implications of Tn elevations in each cardiac and non-cardiac etiology allows the clinician to better distinguish between presentations of myocardial ischemia and myocardial injury-an important discernment to make, as the treatment of acute coronary syndrome is vastly different from the workup and management of myocardial injury and should be directed at the underlying cause. |
doi_str_mv | 10.3390/diagnostics14050503 |
format | article |
fullrecord | <record><control><sourceid>gale_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_09243bee8ca943e09975ba8180808f12</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A786435909</galeid><doaj_id>oai_doaj_org_article_09243bee8ca943e09975ba8180808f12</doaj_id><sourcerecordid>A786435909</sourcerecordid><originalsourceid>FETCH-LOGICAL-c517t-392f6b416a35305695512aaeeb3c069d1b0d1026594bae2a1957a10e157c36fe3</originalsourceid><addsrcrecordid>eNptUk1r3DAQFaWlCdv8gkIx9NKLU31YsnQqYUmbhUAL2Z6FLI-9WmxpK9mB_PvK3TTNlmgEEjPz3mieBqH3BF8ypvDn1pnehzQ5m0iFeTb2Cp1TXPOyqoh8_ex-hi5S2uO8FGGS8rfojMmqpqrm5-jHenDeWTMUGz9BPESYzOSCL0JX3EGcx2IbwyF454u8px0U19EswRvX78o78MlN7t5ND8UW8mt8_w696cyQ4OLxXKGfX6-365vy9vu3zfrqtrSc1FPJFO1EUxFhGGeYC8U5ocYANMxioVrS4JZgKriqGgPUEMVrQzAQXlsmOmArtDnytsHs9SG60cQHHYzTfxwh9trELM8AGitasQZAWqMqBljlzhsjicTZOkIz15cj12FuRmgt-Cma4YT0NOLdTvfhXhOsWCbBmeHTI0MMv-ashB5dsjAMxkOYk6aKCyEpEUuxj_-l7sMcfdZqyeL5c2sp_2X1JnfgfBdyYbuQ6qtaiopxlWuv0OULWdlaGJ0NHjqX_ScAdgTYGFKK0D01SbBeBku_MFgZ9eG5Pk-Yv2PEfgN-k8lS</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2955390788</pqid></control><display><type>article</type><title>Clinical Interpretation of Serum Troponin in the Era of High-Sensitivity Testing</title><source>PubMed (Medline)</source><source>ProQuest Publicly Available Content database</source><creator>Maayah, Marah ; Grubman, Scott ; Allen, Stephanie ; Ye, Zachary ; Park, Dae Yong ; Vemmou, Evangelia ; Gokhan, Ilhan ; Sun, Wendy W ; Possick, Stephen ; Kwan, Jennifer M ; Gandhi, Parul U ; Hu, Jiun-Ruey</creator><creatorcontrib>Maayah, Marah ; Grubman, Scott ; Allen, Stephanie ; Ye, Zachary ; Park, Dae Yong ; Vemmou, Evangelia ; Gokhan, Ilhan ; Sun, Wendy W ; Possick, Stephen ; Kwan, Jennifer M ; Gandhi, Parul U ; Hu, Jiun-Ruey</creatorcontrib><description>Cardiac troponin (Tn) plays a central role in the evaluation of patients with angina presenting with acute coronary syndrome. The advent of high-sensitivity assays has improved the analytic sensitivity and precision of serum Tn measurement, but this advancement has come at the cost of poorer specificity. The role of clinical judgment is of heightened importance because, more so than ever, the interpretation of serum Tn elevation hinges on the careful integration of findings from electrocardiographic, echocardiographic, physical exam, interview, and other imaging and laboratory data to formulate a weighted differential diagnosis. A thorough understanding of the epidemiology, mechanisms, and prognostic implications of Tn elevations in each cardiac and non-cardiac etiology allows the clinician to better distinguish between presentations of myocardial ischemia and myocardial injury-an important discernment to make, as the treatment of acute coronary syndrome is vastly different from the workup and management of myocardial injury and should be directed at the underlying cause.</description><identifier>ISSN: 2075-4418</identifier><identifier>EISSN: 2075-4418</identifier><identifier>DOI: 10.3390/diagnostics14050503</identifier><identifier>PMID: 38472975</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Acute coronary syndromes ; Angina pectoris ; Atherosclerosis ; Biomarkers ; Cardiology ; Cardiovascular disease ; Diagnosis ; Electrocardiography ; Epidemiology ; Etiology ; Heart attacks ; Ischemia ; myocardial infarction ; myocardial injury ; myocardial ischemia ; Patients ; Review ; supply–demand mismatch ; Terminology ; troponin</subject><ispartof>Diagnostics (Basel), 2024-02, Vol.14 (5), p.503</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 by the authors. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c517t-392f6b416a35305695512aaeeb3c069d1b0d1026594bae2a1957a10e157c36fe3</cites><orcidid>0000-0002-5168-4938 ; 0000-0002-3726-1429 ; 0000-0002-0693-0765 ; 0000-0003-1390-508X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2955390788/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2955390788?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38472975$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maayah, Marah</creatorcontrib><creatorcontrib>Grubman, Scott</creatorcontrib><creatorcontrib>Allen, Stephanie</creatorcontrib><creatorcontrib>Ye, Zachary</creatorcontrib><creatorcontrib>Park, Dae Yong</creatorcontrib><creatorcontrib>Vemmou, Evangelia</creatorcontrib><creatorcontrib>Gokhan, Ilhan</creatorcontrib><creatorcontrib>Sun, Wendy W</creatorcontrib><creatorcontrib>Possick, Stephen</creatorcontrib><creatorcontrib>Kwan, Jennifer M</creatorcontrib><creatorcontrib>Gandhi, Parul U</creatorcontrib><creatorcontrib>Hu, Jiun-Ruey</creatorcontrib><title>Clinical Interpretation of Serum Troponin in the Era of High-Sensitivity Testing</title><title>Diagnostics (Basel)</title><addtitle>Diagnostics (Basel)</addtitle><description>Cardiac troponin (Tn) plays a central role in the evaluation of patients with angina presenting with acute coronary syndrome. The advent of high-sensitivity assays has improved the analytic sensitivity and precision of serum Tn measurement, but this advancement has come at the cost of poorer specificity. The role of clinical judgment is of heightened importance because, more so than ever, the interpretation of serum Tn elevation hinges on the careful integration of findings from electrocardiographic, echocardiographic, physical exam, interview, and other imaging and laboratory data to formulate a weighted differential diagnosis. A thorough understanding of the epidemiology, mechanisms, and prognostic implications of Tn elevations in each cardiac and non-cardiac etiology allows the clinician to better distinguish between presentations of myocardial ischemia and myocardial injury-an important discernment to make, as the treatment of acute coronary syndrome is vastly different from the workup and management of myocardial injury and should be directed at the underlying cause.</description><subject>Acute coronary syndromes</subject><subject>Angina pectoris</subject><subject>Atherosclerosis</subject><subject>Biomarkers</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Diagnosis</subject><subject>Electrocardiography</subject><subject>Epidemiology</subject><subject>Etiology</subject><subject>Heart attacks</subject><subject>Ischemia</subject><subject>myocardial infarction</subject><subject>myocardial injury</subject><subject>myocardial ischemia</subject><subject>Patients</subject><subject>Review</subject><subject>supply–demand mismatch</subject><subject>Terminology</subject><subject>troponin</subject><issn>2075-4418</issn><issn>2075-4418</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptUk1r3DAQFaWlCdv8gkIx9NKLU31YsnQqYUmbhUAL2Z6FLI-9WmxpK9mB_PvK3TTNlmgEEjPz3mieBqH3BF8ypvDn1pnehzQ5m0iFeTb2Cp1TXPOyqoh8_ex-hi5S2uO8FGGS8rfojMmqpqrm5-jHenDeWTMUGz9BPESYzOSCL0JX3EGcx2IbwyF454u8px0U19EswRvX78o78MlN7t5ND8UW8mt8_w696cyQ4OLxXKGfX6-365vy9vu3zfrqtrSc1FPJFO1EUxFhGGeYC8U5ocYANMxioVrS4JZgKriqGgPUEMVrQzAQXlsmOmArtDnytsHs9SG60cQHHYzTfxwh9trELM8AGitasQZAWqMqBljlzhsjicTZOkIz15cj12FuRmgt-Cma4YT0NOLdTvfhXhOsWCbBmeHTI0MMv-ashB5dsjAMxkOYk6aKCyEpEUuxj_-l7sMcfdZqyeL5c2sp_2X1JnfgfBdyYbuQ6qtaiopxlWuv0OULWdlaGJ0NHjqX_ScAdgTYGFKK0D01SbBeBku_MFgZ9eG5Pk-Yv2PEfgN-k8lS</recordid><startdate>20240226</startdate><enddate>20240226</enddate><creator>Maayah, Marah</creator><creator>Grubman, Scott</creator><creator>Allen, Stephanie</creator><creator>Ye, Zachary</creator><creator>Park, Dae Yong</creator><creator>Vemmou, Evangelia</creator><creator>Gokhan, Ilhan</creator><creator>Sun, Wendy W</creator><creator>Possick, Stephen</creator><creator>Kwan, Jennifer M</creator><creator>Gandhi, Parul U</creator><creator>Hu, Jiun-Ruey</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7XB</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-5168-4938</orcidid><orcidid>https://orcid.org/0000-0002-3726-1429</orcidid><orcidid>https://orcid.org/0000-0002-0693-0765</orcidid><orcidid>https://orcid.org/0000-0003-1390-508X</orcidid></search><sort><creationdate>20240226</creationdate><title>Clinical Interpretation of Serum Troponin in the Era of High-Sensitivity Testing</title><author>Maayah, Marah ; Grubman, Scott ; Allen, Stephanie ; Ye, Zachary ; Park, Dae Yong ; Vemmou, Evangelia ; Gokhan, Ilhan ; Sun, Wendy W ; Possick, Stephen ; Kwan, Jennifer M ; Gandhi, Parul U ; Hu, Jiun-Ruey</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c517t-392f6b416a35305695512aaeeb3c069d1b0d1026594bae2a1957a10e157c36fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acute coronary syndromes</topic><topic>Angina pectoris</topic><topic>Atherosclerosis</topic><topic>Biomarkers</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Diagnosis</topic><topic>Electrocardiography</topic><topic>Epidemiology</topic><topic>Etiology</topic><topic>Heart attacks</topic><topic>Ischemia</topic><topic>myocardial infarction</topic><topic>myocardial injury</topic><topic>myocardial ischemia</topic><topic>Patients</topic><topic>Review</topic><topic>supply–demand mismatch</topic><topic>Terminology</topic><topic>troponin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maayah, Marah</creatorcontrib><creatorcontrib>Grubman, Scott</creatorcontrib><creatorcontrib>Allen, Stephanie</creatorcontrib><creatorcontrib>Ye, Zachary</creatorcontrib><creatorcontrib>Park, Dae Yong</creatorcontrib><creatorcontrib>Vemmou, Evangelia</creatorcontrib><creatorcontrib>Gokhan, Ilhan</creatorcontrib><creatorcontrib>Sun, Wendy W</creatorcontrib><creatorcontrib>Possick, Stephen</creatorcontrib><creatorcontrib>Kwan, Jennifer M</creatorcontrib><creatorcontrib>Gandhi, Parul U</creatorcontrib><creatorcontrib>Hu, Jiun-Ruey</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest Publicly Available Content database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Diagnostics (Basel)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maayah, Marah</au><au>Grubman, Scott</au><au>Allen, Stephanie</au><au>Ye, Zachary</au><au>Park, Dae Yong</au><au>Vemmou, Evangelia</au><au>Gokhan, Ilhan</au><au>Sun, Wendy W</au><au>Possick, Stephen</au><au>Kwan, Jennifer M</au><au>Gandhi, Parul U</au><au>Hu, Jiun-Ruey</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Interpretation of Serum Troponin in the Era of High-Sensitivity Testing</atitle><jtitle>Diagnostics (Basel)</jtitle><addtitle>Diagnostics (Basel)</addtitle><date>2024-02-26</date><risdate>2024</risdate><volume>14</volume><issue>5</issue><spage>503</spage><pages>503-</pages><issn>2075-4418</issn><eissn>2075-4418</eissn><abstract>Cardiac troponin (Tn) plays a central role in the evaluation of patients with angina presenting with acute coronary syndrome. The advent of high-sensitivity assays has improved the analytic sensitivity and precision of serum Tn measurement, but this advancement has come at the cost of poorer specificity. The role of clinical judgment is of heightened importance because, more so than ever, the interpretation of serum Tn elevation hinges on the careful integration of findings from electrocardiographic, echocardiographic, physical exam, interview, and other imaging and laboratory data to formulate a weighted differential diagnosis. A thorough understanding of the epidemiology, mechanisms, and prognostic implications of Tn elevations in each cardiac and non-cardiac etiology allows the clinician to better distinguish between presentations of myocardial ischemia and myocardial injury-an important discernment to make, as the treatment of acute coronary syndrome is vastly different from the workup and management of myocardial injury and should be directed at the underlying cause.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>38472975</pmid><doi>10.3390/diagnostics14050503</doi><orcidid>https://orcid.org/0000-0002-5168-4938</orcidid><orcidid>https://orcid.org/0000-0002-3726-1429</orcidid><orcidid>https://orcid.org/0000-0002-0693-0765</orcidid><orcidid>https://orcid.org/0000-0003-1390-508X</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 2075-4418 |
ispartof | Diagnostics (Basel), 2024-02, Vol.14 (5), p.503 |
issn | 2075-4418 2075-4418 |
language | eng |
recordid | cdi_doaj_primary_oai_doaj_org_article_09243bee8ca943e09975ba8180808f12 |
source | PubMed (Medline); ProQuest Publicly Available Content database |
subjects | Acute coronary syndromes Angina pectoris Atherosclerosis Biomarkers Cardiology Cardiovascular disease Diagnosis Electrocardiography Epidemiology Etiology Heart attacks Ischemia myocardial infarction myocardial injury myocardial ischemia Patients Review supply–demand mismatch Terminology troponin |
title | Clinical Interpretation of Serum Troponin in the Era of High-Sensitivity Testing |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T14%3A13%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20Interpretation%20of%20Serum%20Troponin%20in%20the%20Era%20of%20High-Sensitivity%20Testing&rft.jtitle=Diagnostics%20(Basel)&rft.au=Maayah,%20Marah&rft.date=2024-02-26&rft.volume=14&rft.issue=5&rft.spage=503&rft.pages=503-&rft.issn=2075-4418&rft.eissn=2075-4418&rft_id=info:doi/10.3390/diagnostics14050503&rft_dat=%3Cgale_doaj_%3EA786435909%3C/gale_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c517t-392f6b416a35305695512aaeeb3c069d1b0d1026594bae2a1957a10e157c36fe3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2955390788&rft_id=info:pmid/38472975&rft_galeid=A786435909&rfr_iscdi=true |