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https://heart.bmj.com/content/102/16/1253
High-sensitivity cardiac troponin at 3 hours: is the cat among the pigeons? In November 2014, the National Institute for Health and Care Excellence (NICE) issued recommendations for the use of high-sensitivity cardiac troponin (hs-cTn) assays in the UK. 1 Two assays were evaluated: the Elecsys hs-cTnT assay (Roche Diagnostics) and the ARCHITECT ...Author: Richard Body, Richard Body, Paul Collinson, Steve Goodacre, Nicholas L Mills, Adam Timmis
https://pubmed.ncbi.nlm.nih.gov/23063209/
For rule-in a 3-hour protocol performed as well as a 6-hour protocol, with a significantly (p<0.0001) better performance of absolute (AUC 0.851 vs. 0.845, p=0.740) as compared to relative concentration changes (AUC 0.771 vs. 0.739, p=0.169). Conclusions: Rule-in and rule-out of non-STEMI may be accomplished comparably effective at 3 or 6h. For rule-in, absolute kinetic changes perform better than relative changes at all time points.Cited by: 71
https://litfl.com/troponin-in-critical-illness/
Jan 07, 2019 · Lower sensitivity troponin requires at least 6 hours between time of initial lab and repeat troponin to see a conclusive increase to rule in AMI Serial sampling of high sensitivity tropinin at 0 and 2 hours can safely rule-out of AMI (can be discharged if TIMI 0 or 1, and normal ECG)Estimated Reading Time: 3 mins
https://www.clinicalcorrelations.org/2019/01/02/core-im-5-pearls-on-troponin/
Jan 02, 2019 · Concerning troponins can be repeated as often as every 2-3 hours. When assessing the acuity of injury, think about troponin trends in terms of changes in log units (i.e. 0.05 to 0.07 vs 0.05 to 5). If suspicious for ACS but no ST changes on EKG, try posterior and right-sided EKG leads!Estimated Reading Time: 10 mins
https://aci.health.nsw.gov.au/networks/eci/clinical/clinical-tools/cardiology/troponin
Dec 03, 2020 · When patients present with chest pain or symptoms suspicious of Acute Coronary Syndrome patients should be put on a Pathway and a troponin measured at zero hours. This should be followed by a repeat troponin at a designated time depending on the assay being used. Current advice is at 2 hours for high sensitivity troponins and 6-8 hrs for standard sensitivity and POC tests such as iSTAT. What to do with the …
https://www.nbt.nhs.uk/sites/default/files/Trop%20w%20%20header.pdf
•The second sample must be no sooner than 3 hours after the first. •A rise or fall in the hs Troponin T will point to an acute diagnosis and possible MI. The patient should be admitted if the change in level is > +/- 7 ng/L (see flowchart). •A stable level suggests a more chronic picture and an alternative diagnosis.
https://emergencymedicinecases.com/low-risk-chest-pain-high-sensitivity-troponin/
Jul 30, 2019 · A normal ECG and a single undetectable hs-troponin drawn 3 hours or more after the onset of symptoms rules out MI at ED arrival in 1/3 of patients and portends a MACE <2% [21]. Two-hour serial testing rules-out MI in 60% of patients, rules-in MI in 15% of patients, leaving only 25% of patients undifferentiated after a 2-hour ED evaluation.
https://www.aliem.com/2018-acep-policy-non-st-elevation-acs/
Dec 17, 2018 · Repeat troponin testing within 3 hours of ED presentation indeed can predict a low rate of 30-day MACE. For conventional troponins, this can be done at 0- and 3-hour negative troponin results. For high sensitivity troponins, a single UNDETECTABLE value at time 0 is enough. A high-sensitivity troponin with a detectable but negative result at 0- and 2-hours also predicts a low 30-day MACE rate.
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