Author + information
- Received October 31, 2018
- Revision received December 5, 2018
- Accepted December 6, 2018
- Published online March 4, 2019.
- James L. Januzzi Jr., MDa,∗ (, )
- Simon A. Mahler, MD, MSb,
- Robert H. Christenson, PhDc,
- Jennifer Rymer, MD, MBAd,
- L. Kristin Newby, MD, MHSd,
- Richard Body, MBChB, PhDe,
- David A. Morrow, MD, MPHf and
- Allan S. Jaffe, MDg
- aCardiology Division, Massachusetts General Hospital, Harvard Medical School, Baim Institute for Clinical Research, Boston, Massachusetts
- bDepartments of Emergency Medicine, Implementation Science, and Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
- cCore Laboratories and Point of Care Services, University of Maryland School of Medicine, Baltimore, Maryland
- dDivision of Cardiology, Department of Medicine and Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
- eDivision of Cardiovascular Sciences, The University of Manchester, Emergency Department, Manchester Royal Infirmary, School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom
- fCardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- gCardiology Department and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
- ↵∗Address for correspondence:
Dr. James L. Januzzi, Jr., Massachusetts General Hospital, Cardiology/Internal Medicine, 33 Fruit Street, Yawkey 5984, Boston, Massachusetts 02114.
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.
Dr. Januzzi is supported in part by the Hutter Family Professorship; has received grant support from Roche Diagnostics, Abbott Diagnostics, Singulex, Prevencio, and Cleveland Heart Labs; has received consulting income from Roche Diagnostics and Critical Diagnostics; and participates in clinical endpoint committees/data safety monitoring boards for Siemens Diagnostics. Dr. Mahler has received research funding from Abbott Point of Care, Roche Diagnostics, Siemens, PCORI, the Donaghue Foundation, and the National Heart, Lung, and Blood Institute; has received consulting honoraria from Roche Diagnostics; and is the chief medical officer for Impathiq Inc. Dr. Christenson has received grant support from Roche Diagnostics, Fujirebio Diagnostics, Beckman Coulter, Siemens Healthcare Diagnostics, Ortho Clinical Diagnostics, Becton Dickinson, Abbott Diagnostics, Mitsubishi, and Horiba Medical; and has consulting agreements with PixCell, Beckman Coulter, Quidel, Siemens Healthineers, and Roche Diagnostics. Dr. Newby has received consulting honoraria from Roche Diagnostics and Ortho-Clinical Diagnostics. Prof. Body has received speaker fees from Roche, Abbott, Beckman, Ortho, ET Healthcare, Medscape, Singulex, Siemens, LumiraDx, and Alere; has received grant support from Roche, Abbott Point of Care, and Singulex; has received donation of reagents for research from Roche, Abbott, Siemens, Alere, Singulex, and FABPulous BV; has served on advisory boards for Roche, LumiraDx, FABPulous BV, and Creavo; and as chair of a trial steering committee for a clinical study sponsored by Creavo. Dr. Morrow has received research grants from Abbott Laboratories, Amgen, AstraZeneca/MedImmune, BRAHMS, Daiichi-Sankyo, Eisai, GlaxoSmithKline, The Medicines Company, Merck, Novartis, Pfizer, Roche Diagnostics, Quark, and Takeda; and serves as a consultant to Abbott Laboratories, Aralez, AstraZeneca, Bayer, InCardia, Merck, Peloton, Pfizer, Roche Diagnostics, and Verseon. Dr. Jaffe has been a consultant for Beckman-Coulter, Abbott, Siemens, ET Healthcare, Quidel, Sphingotec, Novartis, Roche, and Ortho. Dr. Rymer has reported that she has no relationships relevant to the contents of this paper to disclose.
Wolfgang Koenig, MD, served as Guest Associate Editor for this paper.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received October 31, 2018.
- Revision received December 5, 2018.
- Accepted December 6, 2018.
- 2019 American College of Cardiology Foundation
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