PMID- 28466882
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 1759-1104 (Print)
IS  - 1759-1104 (Electronic)
IS  - 1759-1104 (Linking)
VI  - 9
IP  - 1
DP  - 2017
TI  - Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin 
      assays in acute coronary syndromes diagnosis: focus on hs-TnI.
PG  - 81-87
LID - 10.1136/heartasia-2016-010818 [doi]
AB  - 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.
FAU - Tan, Jack Wei Chieh
AU  - Tan JWC
AD  - Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore.
FAU - Lam, Carolyn S P
AU  - Lam CSP
AD  - Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore.
FAU - Kasim, Sazzli Shahlan
AU  - Kasim SS
AD  - Department of Cardiology, Universiti Teknologi MARA, Kuala Lumpur, Malaysia.
FAU - Aw, Tar Choon
AU  - Aw TC
AD  - Department of Laboratory Medicine, Changi General Hospital, Singapore, Singapore.
FAU - Abanilla, Joel M
AU  - Abanilla JM
AD  - Department of Cardiology, Philippine Heart Center, Manila, Philippines.
FAU - Chang, Wei-Ting
AU  - Chang WT
AD  - Department of Cardiology, Chi-Mei Hospital, Tainan, Taiwan.
FAU - Dang, Van Phuoc
AU  - Dang VP
AD  - Department of Cardiology, University Medical Center, Ho Chi Minh City, Vietnam.
FAU - Iboleon-Dy, Maria
AU  - Iboleon-Dy M
AD  - Heart Institute, St Luke's Medical Centre, Quezon City, Philippines.
FAU - Mumpuni, Sari Sri
AU  - Mumpuni SS
AD  - Department of Cardiology, Pondok Indah Hospital, Jakarta, Indonesia.
FAU - Phommintikul, Arintaya
AU  - Phommintikul A
AD  - Department of Cardiology, Chiang Mai University, Chiang Mai, Thailand.
FAU - Ta, Manh Cuong
AU  - Ta MC
AD  - Department of Cardiology, National Cardiology Institute, Hanoi, Vietnam.
FAU - Topipat, Punkiat
AU  - Topipat P
AD  - Department of Cardiology, Siriraj Hospital, Bangkok, Thailand.
FAU - Yiu, Kai Hang
AU  - Yiu KH
AD  - Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong.
FAU - Cullen, Louise
AU  - Cullen L
AD  - Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, 
      Australia.
LA  - eng
PT  - Comment
PT  - Journal Article
DEP - 20170407
PL  - England
TA  - Heart Asia
JT  - Heart Asia
JID - 101542742
CON - Heart Asia. 2017 Apr 7;9(1):88-89. PMID: 28462952
PMC - PMC5388929
OTO - NOTNLM
OT  - CORONARY ARTERY DISEASE
COIS- Competing interests: All authors were provided with logistical support to attend 
      the advisory board meeting. In addition, LC has received institutional research 
      grants and honorarium from Roche, Abbott Diagnostics, Alere, Siemens and 
      Radiometer Pacific. CSPL is supported by a Clinician Scientist Award from the 
      National Medical Research Council of Singapore; has received research support 
      from Boston Scientific, Bayer, Thermofisher, Medtronic and Vifor Pharma and has 
      consulted for Bayer, Novartis, Takeda, Merck, Astra Zeneca, Janssen Research & 
      Development, LLC, Menarini, Boehringer Ingelheim and Abbott.
EDAT- 2017/05/04 06:00
MHDA- 2017/05/04 06:01
PMCR- 2017/04/07
CRDT- 2017/05/04 06:00
PHST- 2016/11/03 00:00 [received]
PHST- 2017/03/12 00:00 [revised]
PHST- 2017/03/14 00:00 [accepted]
PHST- 2017/05/04 06:00 [entrez]
PHST- 2017/05/04 06:00 [pubmed]
PHST- 2017/05/04 06:01 [medline]
PHST- 2017/04/07 00:00 [pmc-release]
AID - heartasia-2016-010818 [pii]
AID - 10.1136/heartasia-2016-010818 [doi]
PST - epublish
SO  - Heart Asia. 2017 Apr 7;9(1):81-87. doi: 10.1136/heartasia-2016-010818. 
      eCollection 2017.