New Lab Test Notification

Premier Pulse     February 2019 Feb 1, 2019

Effective April 24, 2019, CompuNet Clinical Laboratories is switching to a new troponin test, High Sensitivity Troponin T (5th generation) assay, and will discontinue the current Troponin T (4th generation) assay.  This assay is the most recent generation (5th gen) Troponin T testing available and has been employed in Europe, Canada, and Asia since 2009.

Troponin T (TnT) is a component of the contractile apparatus of the striated musculature. Although the function of TnT is the same in all striated muscles, the cardiac isoform of TnT originating exclusively from the myocardium (cardiac TnT, molecular weight 39.7 kDa) clearly differs from skeletal muscle TnT. As a result of its high tissue specificity, cardiac troponin T (cTnT) is a cardio specific, highly sensitive marker for myocardial damage. High Sensitivity Troponin T increases rapidly and can be detected within one hour after AMI and may persist up to two weeks thereafter; thus, conversion to High Sensitivity Troponin T offers the advantages of reduced time to diagnosis with high negative predictive value (Fig 2) and expedited decision making, which improves emergency department length of stay and throughput. Patients who present with symptoms suggestive of acute coronary syndrome should have high sensitivity Troponin T testing interpreted in conjunction with clinical presentation, signs and symptoms, risk stratification with HEART score, ECG testing, imaging, etc. Baseline and serial troponin elevation for significant delta will assist the clinician in differentiating between acute or chronic myocardial injury.

IFCC definition of high sensitivity:

  • Troponin test that can measure cardiac troponin above the limit of detection in ≥ 50 percent of healthy subjects
  • Troponin test that can measure the 99th percentile URL with an analytical imprecision ≤ 10 percent

Compared to the current testing platform, the HS Troponin (5th gen) offers:

  • Reporting in whole numbers (ng/L rather than ng/mL)
  • Sex-specific cutoff points (14 ng/L for females and 22 ng/L for males)
  • Assay Range: 6-10,000 ng/L

For questions about the new Troponin T test, please contact Tywauna Wilson, CompuNet chemistry director, at (937) 297-8243(937) 297-8243.

Back to the February 2019 issue of Premier Pulse

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