Troponin T (Highly Sensitive)

For diagnostic purposes, the results should always be assessed in conjunction with the patient’s medical history, clinical examination and other findings.

The Universal Definition of AMI takes into consideration the ESC/ACC/AHA/WHF definition recommending the detection of a rise and/or fall of cardiac troponin in the clinical setting with at least one value above the 99th percentile upper reference limit.1,2 Due to the release kinetics of cardiac troponin T, an initial test result may not be definitive in diagnosing MI. Serial cardiac troponin measurements are suggested.

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Troponins are released during the process of myocyte necrosis. While they are cardiac-specific, they are not specific for MI, and detectable levels may be seen in other disease states that involve the heart muscle (e.g. arrhythmia, acute aortic syndrome, acute heart failure, hypertensive crisis, myocarditis, pericarditis, pulmonary embolism and Takotsubo cardiomyopathy), so that ACC/ESC/AHA guidelines and the Universal Definition of MI recommend serial sampling with a rise or fall in troponin to distinguish between acute and chronic cTn elevations.

A number of factors other than AMI are associated with elevated values.3-9 Published clinical studies have shown elevations of cardiac troponin T in patients with myocardial injury, as seen in stable or unstable angina, heart failure, myocarditis, pulmonary embolism, pericarditis, arrhythmias, cardiac contusions, and cardiac transplants. Elevations are also notable in patients with rhabdomyolysis and polymyositis.

Samples showing visible signs of hemolysis may cause interference. Falsely depressed results are obtained when using samples with hemoglobin concentrations > 0.1 g/dL.

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For assays using antibodies, the possibility exists for interference by heterophileantibodies in the patient’s sample. Patients who have been regularly exposed to animals or have received immunotherapy or diagnostic procedures using immunoglobulin or immunoglobulin fragments may produce antibodies, e.g. HAMA, that interfere with immunoassays. Carefully evaluate the results of patients suspected ofhaving these antibodies.

In rare cases, interference due to extremely high titers of antibodies to analyte‐specificantibodies, streptavidin or ruthenium can occur. The reagent has been formulated to minimize this effect.

Samples should not be taken from patients receiving therapy with high biotin doses (i.e.> 5 mg/day) until at least 8 hours following the last biotin administration.

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