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Clinical Laboratory Practice Recommendations for the Use of Cardiac Troponin in Acute Coronary Syndrome: Expert Opinion from the Academy of the American Association for Clinical Chemistry and the Task Force on Clinical Applications of Cardiac Bio-Markers of the International Federation of Clinical Chemistry and Laboratory Medicine
Abstract
This document is an essential companion to the third iteration of the National Academy of Clinical Biochemistry [NACB,8 now the American Association for Clinical Chemistry (AACC) Academy] Laboratory Medicine Practice Guidelines (LMPG) on cardiac markers. The expert consensus recommendations were drafted in collaboration with the International Federation of Clinical Chemistry and Laboratory Medicine Task Force on Clinical Applications of Bio-Markers (IFCC TF-CB). We determined that there is sufficient clinical guidance on the use of cardiac troponin (cTn) testing from clinical practice groups. Thus, in this expert consensus document, we focused on clinical laboratory practice recommendations for high-sensitivity (hs)-cTn assays. This document utilized the expert opinion class of evidence to focus on the following 10 topics: (a) quality control (QC) utilization, (b) validation of the lower reportable analytical limits, (c) units to be used in reporting measurable concentrations for patients and QC materials, (d) 99th percentile sex-specific upper reference limits to define the reference interval; (e) criteria required to define hs-cTn assays, (f) communication with clinicians and the laboratory's role in educating clinicians regarding the influence of preanalytic and analytic problems that can confound assay results, (g) studies on hs-cTn assays and how authors need to document preanalytical and analytical variables, (h) harmonizing and standardizing assay results and the role of commutable materials, (i) time to reporting of results from sample receipt and sample collection, and (j) changes in hs-cTn concentrations over time and the role of both analytical and biological variabilities in interpreting results of serial blood collections.
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Cites
A New Equation to Estimate Glomerular Filtration Rate
Levey, A. S., Stevens, L. A., Schmid, C. H., Zhang, Y. (., Castro, A. F., Feldman, H. I., Kusek, J. W., Eggers, P., Van Lente, F., Greene, T., et al. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-150-9-200905050-00006 · Cited by 25,603
Third Universal Definition of Myocardial Infarction
Thygesen, K., Alpert, J. S., Jaffe, A. S., Simoons, M. L., Chaitman, B. R., & White, H. D. (2012) · Circulation · doi:10.1161/cir.0b013e31826e1058 · Cited by 2,985
Self-citationSTARD 2015: An Updated List of Essential Items for Reporting Diagnostic Accuracy Studies
Bossuyt, P. M., Reitsma, J. B., Bruns, D. E., Gatsonis, C. A., Glasziou, P. P., Irwig, L., Lijmer, J. G., Moher, D., Rennie, D., de Vet, H. C. W., et al. (2015) · Clinical Chemistry · doi:10.1373/clinchem.2015.246280 · Cited by 984
Sandberg, S., Fraser, C. G., Horvath, A. R., Jansen, R., Jones, G., Oosterhuis, W., Petersen, P. H., Schimmel, H., Sikaris, K., & Panteghini, M. (2015) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2015-0067 · Cited by 563
Counterpoint: Standardization of Cardiac Troponin I Assays Will Not Occur in My Lifetime
Apple, F. S. (2012) · Clinical Chemistry · doi:10.1373/clinchem.2011.166165 · Cited by 80
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Cited by
Lehmann, L. H., Heckmann, M. B., Bailly, G., Finke, D., Procureur, A., Power, J. R., Stein, F., Bretagne, M., Ederhy, S., Fenioux, C., et al. (2023) · Circulation · doi:10.1161/circulationaha.123.062405 · Cited by 165
Diaz-Garzon, J., Fernandez-Calle, P., Sandberg, S., Özcürümez, M., Bartlett, W. A., Coskun, A., Carobene, A., Perich, C., Simon, M., Marques, F., et al. (2021) · Clinical Chemistry · doi:10.1093/clinchem/hvaa261 · Cited by 42
Metadata
- Authors
- Wu, A. H. B., Christenson, R. H., Greene, D. N., Jaffe, A. S., Kavsak, P. A., Ordonez-Llanos, J., & Apple, F. S.
- Venue
- Clinical Chemistry
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-04-01
- Volume
- 64
- Issue
- 4
- Pages
- 645-655
- ISSN
- 0009-9147 (ISSN-L)
- 1530-8561
- OpenAlex
- W2782580446
- Cited by
- 450
- References
- 5
- FWCI
- 41.46
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Clinical Laboratory Practice Recommendations for the Use of Cardiac Troponin in Acute Coronary Syndrome: Expert Opinion from the Academy of the American Association for Clinical Chemistry and the Task Force on Clinical Applications of Cardiac Bio-Markers of the International Federation of Clinical Chemistry and Laboratory Medicine. https://app.cochat.ai/papers/10.1373/clinchem.2017.277186
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- Wu, A. H. B., Christenson, R. H., Greene, D. N., Jaffe, A. S., Kavsak, P. A., Ordonez-Llanos, J., & Apple, F. S. (2018). Clinical Laboratory Practice Recommendations for the Use of Cardiac Troponin in Acute Coronary Syndrome: Expert Opinion from the Academy of the American Association for Clinical Chemistry and the Task Force on Clinical Applications of Cardiac Bio-Markers of the International Federation of Clinical Chemistry and Laboratory Medicine. Clinical Chemistry. https://doi.org/10.1373/clinchem.2017.277186
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
