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Troponin I | Troponin T | CKMB | Myoglobin | NT-proBNP | CRP | βhCG | D-dimer | PCT

Troponin test: Faster triage with reliable results in 13-19 minutes

The troponin I and troponin T tests are cardiac markers for faster triage of patients with chest pain

Not available in the US

Cardiovascular disease, like acute myocardial infarction and acute coronary syndrome, is one of the most prevalent causes of death in the western world with an estimated 17 million deaths each year on a world-wide basis.

Fast triage of patients with chest pain is essential to allow for initiation of proper and timely diagnosis and treatment.

Troponin I and troponin T are the most specific markers of myocardial infarction, and current guidelines recommend using troponin in the triage of patients with chest pain [1-3].

Basic ScienceTroponin as an aid in diagnosing myocardial infarction

Troponin I and troponin T – TnI and TnT - are proteins of the muscular thin filaments and part of a complex in striated muscle.

Both TnI and TnT exist in skeletal and cardiac forms. The cardiac forms are extremely specific to the heart tissue and are therefore used more and more as specific markers of cardiac muscle damage.

The diagnosis of myocardial infarction (MI) is based on the detection of a rise and/or fall of cardiac specific markers such as troponin I or troponin T in combination with ECG or imaging methods, ischemic symptoms or other clinical findings.

For patients with myocardial infarction, troponins are released into the bloodstream after the onset of chest pain and elevated troponin levels can usually be detected after 4-8 hours with the peak troponin levels generally reached around 12-48 hours [3, 4].

CRP values and antibiotic treatmentTroponin tests at the Emergency Department

When a patient arrives at the Emergency Department with chest pain and no significant changes on the electrocardiography (ECG), the ED physician typically orders a series of troponin tests.

This is to establish if the symptoms are caused by an acute myocardial infarction (AMI) – a heart attack - and to determine the next steps which could either be transferring the patient to the angiography ward for potential intervention – or possibly discharge him from the hospital.

Point-of-careTroponin tests at the point of care

The AQT90 FLEX TnI test and the AQT90 FLEX TnT test are indicated for use as an aid in diagnosing myocardial infarction and in the stratification of patients with acute coronary syndromes.

The AQT90 FLEX immunoassay analyzer measures troponin I (TnI) and troponin T (TnT) on whole blood and is suitable for point-of-care testing:

  • No sample preparation, no sample transport
  • Fast time-to-result, no waiting for technical staff, no phone calls to get result
  • Size of analyzer suits both emergency departments (ED) and cardiac wards
  • Easy to use and maintain

 

With the hematocrit correction, whole blood and plasma can be used interchangeably [5,6]

CRP test on the AQT90 FLEX analyzerQuick facts on the troponin I and troponin T assays

  • Specimen types: venous whole blood and plasma
  • Sample tubes: Fits most 13 × 75 mm standard tubes
  • No blood exposure: closed system
  • No sample or assay preparation
  • High analytical performance
  • No presence of hook effect, carry-over or known interferences at clinically relevant concentrations.
  • Interference from heterophilic antibodies are minimized in both assays by adding a blocker substance

 

Assay specifics           

TnT

TnI

Turnarond time

< 13 min

< 19 min

CV% (plasma)

Within-lab CV% at conc. 0.027 µg/L: 9.6 %

Within-lab CV% at conc. 0.021 µg/L: 12.9 %

99th % percentile

0.017 μg/L

0.023 μg/L

Traceability

Harmonized to correlate with results of 4th generation TnT assay for the Roche Elecsys 2010 system.

Traceable to the NIST standard SRM 2921

 

  1. WHO estimate - http://www.who.int/topics/cardiovascular_diseases/en/.
  2. Johnston S, Brightwell R, Ziman M. Paramedics: Paramedics and pre-hospital management of acute myocardial infarction: diagnosis and reperfusion. Review. Emergency Medicine Journal 2006; 23: 331-34.
  3. Thygesen K, Alpert JS, White HD on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction: Universal Definition of Myocardial Infarction. Circulation 2007; 116(22): 2634-2653.
  4. Seeger C et al. Acute care testing handbook 2014
  5. Whole blood vs. Plasma results on the AQT90 FLEX analyzer – Troponin T. Copenhagen: Radiometer Medical ApS, 2011. Code no. 939-275
  6. Whole blood vs. Plasma results on the AQT90 FLEX analyzer – Troponin I. Copenhagen: Radiometer Medical ApS, 2011. Code no. 939-278

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