Improved efficiency and cost reduction in the emergency department by replacing contemporary sensitive with high-sensitivity cardiac troponin immunoassay Commentary to the Article on high-sensitivity cardiac troponin immunoassay. ACTA BIOMEDICA 2019,Vo. 90,N°4:414-620
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Keywords
troponin immunoassay; non-ST elevation coronary syndromes (NSTEMI)
Abstract
The Authors planned this study to evaluate the impact of replacing a contemporary-sensitive with HS cTnI immunoassay on hospital and laboratory workload.
The authors say that, ‘Despite some evidence, the clinicians are still hesitant to replace the former so-called contemporary-sensitive methods with HS-cTn techniques, justifying this reluctance with concerns of overutilization, possible over diagnosis of cardiac injuries, overcrowding of emer-gency departments (EDs), and excess of cardiac invasive testing. Several factors have lead clinicians to use terms such as “troponin leak”, “false-positive” troponin elevation, or “troponinemia”. The results of this study show substantial organizational and economic benefits by replacing con-temporary-sensitive with HS cTnI immunoassays. This is very important question because there are some areas such as acute non-ST elevation coro-nary syndromes (NSTEMI) and in elderly patients, the specificity is very low for the simultaneous presence of factors that can alter the dosage of HS-cTnI values.
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References
2) Vafaie M, Biener M, Mueller M, Schnabel PA, André F, Steen H, et al. Analytically false or true positive elevations of high sensitivity cardiac troponin: A systematic approach. Heart. 2014;100:508–14
3) ‘HIGH-SENSITIVITY TROPONIN ASSAYS EXHIBIT PROHIBITIVELY HIGH FALSE POSITIVE RATES FOR MYOCARDIAL INFARCTION IN THE ELDERLY: FINDINGS FROM THE AGES REYKJAVIK STUDY Tushar Acharya and coll, on Jour-nal of the American College of Cardiology Volume 71, Issue 11 Supplement, March 2018,