Cardiac markers are used in the diagnosis and stratification of risk in patients with chest pain, suspected of having an acute coronary syndrome. Cardiac troponins, in particular, have become the preferred biomarkers for patients with ACS.
The use of troponin as a "gold standard" biochemical marker has rapidly led to an increase in the number of patients for whom the potential myocardial infarction diagnostic is not real, although they exhibit an elevated level of troponin. Chronic elevated levels of troponin have been observed in patients with renal impairment. Recommendations to use a threshold value for the 99th percentile together with the improved test sensitivity have led to an increase in pathologies associated with elevated levels of troponin.
The European Cardiology Guide recommends testing patients with high-sensitivity troponin at intake and after three hours or, at intake and after one hour if there are validation studies of the algorithm 0/1 h.
Repeated testing allows immediate discrimination between acute and chronic myocardial injury. This solves the dilemma of patients with chronic kidney disease or other cardiac pathologies, associated with elevated levels of troponin. An elevated level of troponin is expected in patients with renal insufficiency. A change in troponin concentration indicates an acute injury and may be associated with a myocardial infarction. Instead, an increased level of troponin that does not vary over time indicates a chronic condition and requires additional investigations.
Learn more about the unique Point-of-Care equipment that can determine HS Troponin here.
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