Cor Vasa 2021, 63(6):703-709 | DOI: 10.33678/cor.2021.064

(Overview and application of validated algorithms using high-sensitivity cardiac troponin assays for early diagnosis of acute myocardial infarction)

Vladimír Jakubo^{a, b}, Tomáš Ondrúš^{a, b}, Miroslava Beňovská^{c, d}, Martin Doleček^e, Andrea Křivanová^{f, g}, Hana Šimáčková^h, Tomáš Zatočil^a, Petr Kala^{a, b}, Jiří Pařenica^{a, b}, Petr Lokaj^{a, b}

^a Interní kardiologická klinika, Fakultní nemocnice Brno, Brno

^b Interní kardiologická klinika, Lékařská fakulta Masarykovy univerzity, Brno

^c Ústav laboratorní medicíny - Oddělení klinické biochemie, Fakultní nemocnice Brno, Brno

^d Katedra laboratorních metod, Lékařská fakulta Masarykovy univerzity, Brno

^e Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Brno, Brno

^f Interní hematoonkologická klinika, Fakultní nemocnice Brno, Brno

^g Interní hematoonkologická klinika, Lékařská fakulta Masarykovy univerzity, Brno

^h Klinika interní, geriatrie a praktického lékařství, Fakultní nemocnice Brno, Brno

Chest pain is one of the leading reasons for emergency department visits and the chief symptom of acute myocardial infarction (AMI). The measurement of myocardial injury biochemical markers' blood level is essential for the diagnosis of AMI. Cardiac troponin is the current international gold standard marker. The contemporary expansion in the usage of high-sensitivity assays that can detect cardiac troponin at very low levels presents a challenge for accurate interpretation of results. European Society of Cardiology guidelines prioritize the employment of validated rule out/rule in algorithms to rule out AMI safely and rapidly and/or to early identification of patients with high risk for AMI and initiation of their therapy. This article presents comprehensible information about use of high-sensitivity cardiac troponins in clinical practice. It also provides algorithms preferred by European Society of Cardiology and useful information to interpret results in specific groups of patients.

Keywords: Acute coronary syndrome, Acute myocardial infarction, Algorithm, High-sensitivity troponin

Received: May 1, 2021; Revised: May 1, 2021; Accepted: May 23, 2021; Published: December 13, 2021  Show citation