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Unique Aspects of High Sensitivity Assays: What Are They, Why Do We Need Them, and How Do We Use Them?

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Cardiac Biomarkers

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Abstract

The development of immunoassays for the cardiac troponins (cTn) either cardiac troponin T (cTnT) or cardiac troponin I (cTnI) resulted in a paradigm shift in biochemical testing for the diagnosis of patients presenting with chest pain. For the first time, the laboratory was able to offer a specific diagnostic test for acute myocardial infarction (AMI). Compared to the tests then in use, measurement of creatine kinase (CK) and its MB isoenzyme (CK-MB), the measurement of cTnT or cTnI offered not only superior diagnostic efficiency but also prognostic information and treatment guidance. The superiority of cTnT and cTnI measurement led initially to the redefinition of myocardial infarction. This stated that the preferred biomarker for diagnosis of AMI was serial troponin measurement [1]. This document first recommended that the 99th percentile should be used as decision limit and the analytical imprecision of the assay (the coefficient of variation, CV) should be ≤10 % at the 99th percentile. It is worth remembering that at this point the analytical sensitivity of the available assays, although clinically superior to that of CK and CK-MB measurement was significantly less than those currently in use.

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Authors and Affiliations

  1. Clinical Blood Sciences and Cardiology, St George’s Hospital and Medical School, London, UK

    Paul Ormandy Collinson MA, MB, BChir, FRCPath, MD

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  1. Paul Ormandy Collinson MA, MB, BChir, FRCPath, MD
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Correspondence to Paul Ormandy Collinson MA, MB, BChir, FRCPath, MD .

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Editors and Affiliations

  1. Division of Cardiovascular Medicine, University of California San Diego Division of Cardiovascular Medicine, La Jolla, California, USA

    Alan S. Maisel

  2. Cardiology Department, Mayo Clinic Cardiology Department, ROCHESTER, Minnesota, USA

    Allan S. Jaffe

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Collinson, P.O. (2016). Unique Aspects of High Sensitivity Assays: What Are They, Why Do We Need Them, and How Do We Use Them?. In: Maisel, A., Jaffe, A. (eds) Cardiac Biomarkers. Springer, Cham. https://doi.org/10.1007/978-3-319-42982-3_3

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  • DOI: https://doi.org/10.1007/978-3-319-42982-3_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42980-9

  • Online ISBN: 978-3-319-42982-3

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