Troponin I - Woodwinds
| Abbrev Code: | TROPI | ||
| Order Code: | LAB747 | Order Name: | Troponin I |
| Methodology: | CMIA | ||
| CPT Codes: | 84484 x1 | ||
| Turnaround Time: | Performed and reported 24 hours/day. | ||
| Associated Links: | |||
Collection Instructions
| Specimen: | Blood |
| Optimal Volume: | 2.5 mL |
| Minimum\Peds Volume: | 0.6 mL |
| Container: | Green (lithium heparin, no gel) Alternate Containers: Red (no gel) |
| Collection Instructions: | Serial sampling is recommended to detect temporal rise and fall of cTnI levels characteristic of AMI. |
| Contraindications: | Large doses of biotin (10 mg or more per day) may cause clinically significant interference in troponin levels. If interference is suspected, it is strongly recommended that biotin is discontinued for at least one week prior to retesting. |
Processing and Shipping
| Specimen Processing: | Centrifuge and aliquot 1.25 mL, 0.2 mL minimum. Store in refrigerator. |
| Shipping Instructions: | Ship at refrigerated temperature to arrive within 48 hours. Alternatively, ship on dry ice. |
| Stability: | 2 days refrigerated; 8 weeks frozen. |
| Test Performed at or Referral Lab | Chemistry (Woodwinds) |
Interpretive
| Critical Range: | Woodwinds: Greater than 0.29 mg/mL |
| Reference Range: | Woodwinds: 0.00-0.29 ng/mL |
| Limitations: | 1) Interpretation of cTnI results should be done only in the context of the overall clinical picture, e.g., clinical history, ECG, and other laboratory tests indicative of cardiac damage. The triage of patients with chest pain should be based on serial samples and the typical rise and fall pattern of cTnI charcteristic of cardiac damage.
2) For troubleshooting purposes, if the cTnI result is inconsistent with the clincial picture and is persistently elevated, the sample should be tested for the presence of heterophilic antibodies. These antibodies may be present in the blood samples from individuals regularly exposed to animals who have been treated with animal serum products. 3) Samples from patients receiving preparations of mouse monoclonal antibodies for therapy or diagnosis may contain Human Anti-Mouse Antibodies (HAMA). Such samples may show either falsely elevated or falsely depressed values when tested with this method. 4) Streptokinase may interfere negatively with the predicted concentration of cTnI. Care should be taken when interpreting cTnI results after administration of streptokinase. |
| Use: | The National Academy of Clinical Biochemistry Standards of Laboratory Practices (NACB) and the International Federation of Clinical Chemistry (IFCC) recommend a minimum of three serial blood samples within 24 hours of admission. Serial sampling is recommended to detect the temporal rise and fall of cTnI levels characteristic of AMI.
The Joint European Society of Cardiology/American College of Cardiology (ESC/ACC) and the NACB recommend that the diagnosis of AMI includes the presence of clinical history suggestive of Acute Coronary Syndrome (ASC) and a maximum concentration of cardiac troponin exceeding the 99th percentile of a normal reference population [upper reference limit (URL)] on at least one occasion during the first 24 hours after the clinical event. The World Health Organization (WHO) requires two of the following criteria for the diagnosis of AMI: elevated cardiac markers results, evolutionary changes in ECG, history of chest pain. Increased cTnI concentrations can be found in conditions other than AMI that can resut in myocardial damage. These conditions include, but are not limited to, sepsis, congestive heart failure, hypertension with left ventricular hypertrophy, hemodynamic compromise, myocarditis, mechanical injury including cardiac surgery, defibrillation and cardiac toxins such as anthracyclines. Factors such as these should be considered when interpreting results from any cTnI test method. |
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