Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Baim Institute for Clinical Research, Boston, Massachusetts.
Departments of Emergency Medicine, Implementation Science, and Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina.
J Am Coll Cardiol. 2019 Mar 12;73(9):1059-1077. doi: 10.1016/j.jacc.2018.12.046. Epub 2019 Feb 21.
High-sensitivity cardiac troponin (hs-cTn) I or T methods have been in use in certain regions for years but are now increasingly globally adopted, including in the United States. Accordingly, inevitable challenges are created for institutions transitioning from conventional cardiac troponin (cTn) assays. hs-cTn assays have higher analytic precision at lower concentrations, yielding greater clinical sensitivity for myocardial injury and allowing accurate recognition of small changes in troponin concentration (rise or fall) within a short time frame. Although much of the knowledge regarding troponin biology that was applicable with older troponin assays still holds true, considerable education regarding the differences between conventional cTn and hs-cTn is needed before medical systems convert to the newer methods. This includes a basic understanding of how hs-cTn testing differs from conventional cTn testing and how it is best deployed in different settings, such as the emergency department and inpatient services. This Expert Panel will review important concepts for institutional transition to hs-cTn methodology, providing recommendations useful for education before implementation.
高敏心肌肌钙蛋白（hs-cTn）I 或 T 方法已在某些地区使用多年，但现在正越来越在全球范围内被采用，包括在美国。因此，对于从传统心肌肌钙蛋白（cTn）检测方法过渡的机构来说，不可避免地会带来一些挑战。hs-cTn 检测方法在较低浓度下具有更高的分析精度，从而提高了心肌损伤的临床灵敏度，并能够准确识别短时间内肌钙蛋白浓度的微小变化（升高或降低）。尽管与旧的肌钙蛋白检测方法相关的许多关于肌钙蛋白生物学的知识仍然适用，但在医疗系统转换为新方法之前，需要进行大量关于传统 cTn 和 hs-cTn 之间差异的教育。这包括对 hs-cTn 检测与传统 cTn 检测的区别以及如何在不同环境（如急诊科和住院部）中最佳应用的基本了解。本专家小组将回顾向 hs-cTn 方法学过渡的机构的重要概念，并提供实施前教育的有用建议。
