High-sensitivity cardiac troponin: do think twice, it's not all right

Clin Chem Lab Med. 2017 Oct 26;55(11):1669-1671. doi: 10.1515/cclm-2017-0025.

Abstract

A questionable scientific approach to measuring at low concentrations and inappropriate censoring of results below certain cut-offs have resulted in the dichotomous classification of troponin assays based on their so-called analytical sensitivity. The definition of "high-sensitivity" cardiac troponin is flawed. Evidence suggests that its apparent diagnostic superiority may be explained by the censoring of data. In the evaluation of the detection and quantification capabilities of analytical methods we recommend alignment with International Union of Pure and Applied Chemistry (IUPAC) guidelines, including reporting of all results. This will allow the objective evaluation of the diagnostic performance of troponin assays and will render the current troponin assay classification and nomenclature obsolete.

Keywords: analytical sensitivity; high-sensitivity cardiac troponin; limit of detection; limit of the blank; myocardial infarction; troponin.

MeSH terms

  • Biological Assay
  • Confidence Intervals
  • Guidelines as Topic
  • Humans
  • Limit of Detection
  • Myocardial Infarction / diagnosis*
  • Sensitivity and Specificity
  • Troponin / analysis*

Substances

  • Troponin