PMID- 23787156
OWN - NLM
STAT- MEDLINE
DCOM- 20140423
LR  - 20151119
IS  - 1876-4738 (Electronic)
IS  - 0914-5087 (Linking)
VI  - 62
IP  - 4
DP  - 2013 Oct
TI  - Increasing specificity of high-sensitivity troponin: new approaches and 
      perspectives in the diagnosis of acute coronary syndromes.
PG  - 205-9
LID - S0914-5087(13)00143-3 [pii]
LID - 10.1016/j.jjcc.2013.04.005 [doi]
AB  - In the past years, new generations of assays to detect cardiac troponin (cTn), 
      called sensitive or high sensitivity troponin (hs-Tn), have been introduced. 
      Progressive improvement in the analytical sensitivity of cTn assays has led to a 
      more rapid diagnosis of acute myocardial infarction (AMI) and improved risk 
      stratification in patients with non ST-elevation acute coronary syndromes 
      (NSTE-ACS) but, at the same time, has introduced the problem of a lower 
      diagnostic specificity. As a matter of fact, hs-Tn assays are able to detect very 
      small increases in the biomarker concentration and therefore result "positive" in 
      a wide range of non-ischemic clinical conditions, acute and chronic, cardiac and 
      extra-cardiac. The reduced specificity of hs-Tn versus the previous generation 
      cTn assays may, therefore, lead to an increased number of inappropriate 
      hospitalizations, i.e. patients with high cTn due to no-ACS conditions, and 
      requires a more careful evaluation, not only on the clinical side, but also on 
      the information that hs-Tn assessment may provide. Several approaches to increase 
      this specificity have been used, but the most promising appear to be the "delta 
      approach", which tries to quantify the relative or absolute change in cTn 
      concentration, and the "age approach", which highlights the need for a different 
      cutoff with a better diagnostic efficiency in the elderly population, often 
      affected by other conditions, different from ACS, that can cause an increased 
      level of cTn.
CI  - Copyright (c) 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Marini, Maria Giulia
AU  - Marini MG
AD  - Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
FAU - Cardillo, Maria Teresa
AU  - Cardillo MT
FAU - Caroli, Annalisa
AU  - Caroli A
FAU - Sonnino, Chiara
AU  - Sonnino C
FAU - Biasucci, Luigi M
AU  - Biasucci LM
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20130617
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
RN  - 0 (Biomarkers)
RN  - 0 (Troponin)
SB  - IM
MH  - Acute Coronary Syndrome/blood/*diagnosis
MH  - Age Factors
MH  - Biomarkers/blood
MH  - Humans
MH  - Immunoassay/methods/trends
MH  - Sensitivity and Specificity
MH  - Troponin/*blood
OTO - NOTNLM
OT  - Acute coronary syndrome
OT  - High sensitivity troponin
OT  - "Age approach"
OT  - "Delta approach"
EDAT- 2013/06/22 06:00
MHDA- 2014/04/24 06:00
CRDT- 2013/06/22 06:00
PHST- 2013/04/03 00:00 [received]
PHST- 2013/04/16 00:00 [revised]
PHST- 2013/04/22 00:00 [accepted]
PHST- 2013/06/22 06:00 [entrez]
PHST- 2013/06/22 06:00 [pubmed]
PHST- 2014/04/24 06:00 [medline]
AID - S0914-5087(13)00143-3 [pii]
AID - 10.1016/j.jjcc.2013.04.005 [doi]
PST - ppublish
SO  - J Cardiol. 2013 Oct;62(4):205-9. doi: 10.1016/j.jjcc.2013.04.005. Epub 2013 Jun 
      17.