Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: Focus on hs-TnI

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 a...

Full description

Saved in:
Bibliographic Details
Main Authors: Jack Wei Chieh Tan, Carolyn S.P. Lam, Sazzli Shahlan Kasim, Tar Choon Aw, Joel M. Abanilla, Wei Ting Chang, Van Phuoc Dang, Maria Iboleon-Dy, Sari Sri Mumpuni, Arintaya Phommintikul, Manh Cuong Ta, Punkiat Topipat, Kai Hang Yiu, Louise Cullen
Format: Journal
Published: 2018
Subjects:
Online Access:https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85017503890&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/57731
Tags: Add Tag
No Tags, Be the first to tag this record!
Institution: Chiang Mai University
id th-cmuir.6653943832-57731
record_format dspace
spelling th-cmuir.6653943832-577312018-09-05T03:48:46Z Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: Focus on hs-TnI Jack Wei Chieh Tan Carolyn S.P. Lam Sazzli Shahlan Kasim Tar Choon Aw Joel M. Abanilla Wei Ting Chang Van Phuoc Dang Maria Iboleon-Dy Sari Sri Mumpuni Arintaya Phommintikul Manh Cuong Ta Punkiat Topipat Kai Hang Yiu Louise Cullen Medicine 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. 2018-09-05T03:48:46Z 2018-09-05T03:48:46Z 2017-04-01 Journal 17591104 2-s2.0-85017503890 10.1136/heartasia-2016-010818 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85017503890&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/57731
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Jack Wei Chieh Tan
Carolyn S.P. Lam
Sazzli Shahlan Kasim
Tar Choon Aw
Joel M. Abanilla
Wei Ting Chang
Van Phuoc Dang
Maria Iboleon-Dy
Sari Sri Mumpuni
Arintaya Phommintikul
Manh Cuong Ta
Punkiat Topipat
Kai Hang Yiu
Louise Cullen
Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: Focus on hs-TnI
description 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.
format Journal
author Jack Wei Chieh Tan
Carolyn S.P. Lam
Sazzli Shahlan Kasim
Tar Choon Aw
Joel M. Abanilla
Wei Ting Chang
Van Phuoc Dang
Maria Iboleon-Dy
Sari Sri Mumpuni
Arintaya Phommintikul
Manh Cuong Ta
Punkiat Topipat
Kai Hang Yiu
Louise Cullen
author_facet Jack Wei Chieh Tan
Carolyn S.P. Lam
Sazzli Shahlan Kasim
Tar Choon Aw
Joel M. Abanilla
Wei Ting Chang
Van Phuoc Dang
Maria Iboleon-Dy
Sari Sri Mumpuni
Arintaya Phommintikul
Manh Cuong Ta
Punkiat Topipat
Kai Hang Yiu
Louise Cullen
author_sort Jack Wei Chieh Tan
title Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: Focus on hs-TnI
title_short Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: Focus on hs-TnI
title_full Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: Focus on hs-TnI
title_fullStr Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: Focus on hs-TnI
title_full_unstemmed Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: Focus on hs-TnI
title_sort asia-pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis: focus on hs-tni
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85017503890&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/57731
_version_ 1681424933365743616