![]() ![]() Appropriate use, however, requires a keen understanding of their utility and potential challenges, matched to clinical acumen. On the other hand, these assays offer tremendous advantages in assessing chest pain and, if used properly, may save lives, reduce ED overcrowding, and spare scant health care dollars. In a lab, it is one thing, but many fear that these assays, once they arrive in US emergency departments (EDs), will create rampant troponinitis, overwhelming inpatient cardiology services with wrongly diagnosed patients or "just-in-case" or "CYA" referrals. Oh, and under the category "let's-not-even-go-there," there are troponin "elevations" due to analytical causes that are assay-based (due to poor performance or calibration errors) or sample-based (due to the susceptibility of troponin assays to interfering substances, such as heterophile antibodies and rheumatoid factor). When stable coronary artery disease starts to look like ACS to the untrained eye, referral becomes as common as a breeze. Maybe two of the biggest headaches: procedure-related troponin elevations (due to percutaneous coronary intervention, for example, where procedural myocardial infarction rates may uptick dramatically with hs troponin assays compared to CK-MB assessment) or troponin triggered by increased demand on a stable lesion. Translation: when you can measure almost any elevation in troponin, then almost anything can be the problem.ĭetectable troponin could be due to myocarditis, Takotsubo cardiomyopathy, heart failure, hypertensive urgency, trauma, cardioversion or cardiopulmonary resuscitation, atrial fibrillation with rapid ventricular response, chronic kidney disease, sepsis, pulmonary embolism-or any of several dozen possibilities. The term describes a scenario where a high-sensitivity (hs) cardiac troponin immunoassay detects leaking troponin above the 99th percentile of a reference population in a patient not experiencing an acute coronary syndrome (ACS). ![]() but it is fun when scientists get creative with scientific jargon. There is a new condition on the horizon that hurts the brain just thinking about it: troponinitis. Editor's Note: This was originally published in the June, 2014 issue of CardioSource WorldNews in the Column "Classified: Controversial and Highly Sensitive" authored by Debra L. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |