Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: Focus on hs-TnI

Objective High-sensitivity troponin (hs-Tn) assays need to be applied appropriately to improve diagnosis and patient outcomes in acute coronary syndromes (ACS). Methods Experts from Asia Pacific convened in 2015 to provide data-driven consensus-based, region-specific recommendations and develop an a...

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Main Authors: Abanilla, J.M (Author), Aw, T.C (Author), Chang, W.-T (Author), Cullen, L. (Author), Dang, V.P (Author), Iboleon-Dy, M. (Author), Kasim, S.S (Author), Lam, C.S.P (Author), Mumpuni, S.S (Author), Phommintikul, A. (Author), Ta, M.C (Author), Tan, J.W.C (Author), Topipat, P. (Author), Yiu, K.H (Author)
Format: Article
Language:English
Published: BMJ Publishing Group 2017
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Online Access:View Fulltext in Publisher
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LEADER 03488nam a2200505Ia 4500
001 10.1136-heartasia-2016-010818
008 220120s2017 CNT 000 0 und d
020 |a 17591104 (ISSN) 
245 1 0 |a Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: Focus on hs-TnI 
260 0 |b BMJ Publishing Group  |c 2017 
520 3 |a Objective High-sensitivity troponin (hs-Tn) assays need to be applied appropriately to improve diagnosis and patient outcomes in acute coronary syndromes (ACS). Methods Experts from Asia Pacific convened in 2015 to provide data-driven consensus-based, region-specific recommendations and develop an algorithm for the appropriate incorporation of this assay into the ACS assessment and treatment pathway. Results Nine recommendations were developed by the expert panel: (1) troponin is the preferred cardiac biomarker for diagnostic assessment of ACS and is indicated for patients with symptoms of possible ACS; (2) hs-Tn assays are recommended; (3) serial testing is required for all patients; (4) testing should be performed at presentation and 3 hours later; (5) gender-specific cut-off values should be used for hs-Tn I assays; (6) hs- Tn I level >10 times the upper limit of normal should be considered to rule in a diagnosis of ACS; (7) dynamic change >50% in hs-Tn I level from presentation to 3- hour retest identifies patients at high risk for ACS; (8) where only point-of-care testing is available, patients with elevated readings should be considered at high risk, while patients with low/undetectable readings should be retested after 6 hours or sent for laboratory testing and (9) regular education on the appropriate use of troponin tests is essential. Conclusions We propose an algorithm that will potentially reduce delays in discharge by the accurate rule out of non-ACS patients within 3 hours. Appropriate research should be undertaken to ensure the efficacy and safety of the algorithm in clinical practice, with the long-term goal of improvement of care of patients with ACS in Asia Pacific. 
650 0 4 |a acute coronary syndrome 
650 0 4 |a acute heart infarction 
650 0 4 |a Article 
650 0 4 |a cardiac troponin 1 CLIA kit 
650 0 4 |a diagnostic accuracy 
650 0 4 |a differential diagnosis 
650 0 4 |a echocardiography 
650 0 4 |a electrocardiography 
650 0 4 |a human 
650 0 4 |a limit of detection 
650 0 4 |a point of care testing 
650 0 4 |a predictive value 
650 0 4 |a sensitivity and specificity 
650 0 4 |a sex difference 
650 0 4 |a thorax pain 
650 0 4 |a troponin I 
650 0 4 |a troponin T 
700 1 0 |a Abanilla, J.M.  |e author 
700 1 0 |a Aw, T.C.  |e author 
700 1 0 |a Chang, W.-T.  |e author 
700 1 0 |a Cullen, L.  |e author 
700 1 0 |a Dang, V.P.  |e author 
700 1 0 |a Iboleon-Dy, M.  |e author 
700 1 0 |a Kasim, S.S.  |e author 
700 1 0 |a Lam, C.S.P.  |e author 
700 1 0 |a Mumpuni, S.S.  |e author 
700 1 0 |a Phommintikul, A.  |e author 
700 1 0 |a Ta, M.C.  |e author 
700 1 0 |a Tan, J.W.C.  |e author 
700 1 0 |a Topipat, P.  |e author 
700 1 0 |a Yiu, K.H.  |e author 
773 |t Heart Asia  |x 17591104 (ISSN)  |g 9 1 
856 |z View Fulltext in Publisher  |u https://doi.org/10.1136/heartasia-2016-010818 
856 |z View in Scopus  |u https://www.scopus.com/inward/record.uri?eid=2-s2.0-85017503890&doi=10.1136%2fheartasia-2016-010818&partnerID=40&md5=d93fd16d489d7fc961c7ba8fcff9e44a