Troponin T High Sensitivity - CSC Mpls, East, Lakes, Ridges, St. John's


Abbrev Code:TROPT   
Order Code:LAB8259Order Name:Troponin T, High Sensitivity
Synonyms:Cardiac Enzyme
Methodology:Electrochemiluminescence immunoassay (ECLIA)
CPT Codes: 84484 x1, 84484 x1
Turnaround Time:Performed and reported 24 hours/day
Special Instructions:Starting June 21 at 10 am; all Troponin testing done at the East Bank lab will use high sensitivity Troponin T.
  • Troponin T has different threshold values for clinical decisions and different reference ranges than high-sensitivity and contemporary Troponin I.    
  • Troponin T results will trend on a new line in the Results Review in Epic.  
  • The result values and reference ranges are different than high-sensitivity and contemporary Troponin I.  
  • An updated algorithm will be linked in each of the high-sensitivity Troponin Epic orders.   
  • Algorithms for High Sensitivity Troponin T and High Sensitivity Troponin I.
  • tailed information about the assay is explained in this video, which has been custom-produced by Roche for MHealth: Roche Troponin T- MHealth Fairview Guide.
Associated Links:

Roche Go Live Schedule



Collection Instructions

Specimen:Blood
Optimal Volume:2.5 mL
Minimum\Peds Volume:0.6 mL
Collection Instructions:Chemistry Tests Containers Chart
Serial sampling is recommended to detect temporal rise and fall of cTnl levels characteristic of AMI.


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 24  hours. Alternatively, ship on dry ice.
Fairview Clinics: Ship samples to arrive the same day.
Stability:24 hours refrigerated; 12 months frozen. Freeze only once.
Test Performed at or Referral Lab Chemistry  (Roche-CSC Mpls, Roche-Lakes, Roche-Ridges, Roche-St. John's, Roche-UMMC East)


Interpretive

Critical Range:≥100 ng/L
Reference Range:High Sensitivity Troponin T 
99th percentile cutoffs:
Female all ages <14 ng/L
Male all ages <22 ng/L
 
Limitations:Interpretation of cTnl 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 cTnl characteristic of cardiac damage.
Use:The International Federation for Clinical Chemistry and Lab Medicine (IFCC) standard, defines "high sensitivity" cardiac troponin assay as the ability to detect troponin I concentrations precisely with a coefficient of variation, <10 at or below the 99th percentile URL and measurable in >50% of normal healthy individuals. Compared to contemporary troponin I assays, high sensitivity troponin I assays can detect lower levels of troponin I with improved precision and more reliable changes in ta patient's troponin levels to aid in timely diagnosis of AMI.
Clinically validated rule-in/out algorithms specific for high sensitivity assay can help achieve high sensitivity and specificity for the detection of acute MI at presentation and shorten the time interval to the second cardiac troponin. These might substantially reduce the delay to diagnosis, translating into shorter stays in the emergency department and lower costs.


Values are reported in μg/L and high sensitivity cardiac troponin (hs-cTn) assays are reported in ng/L. If the concentration is substantially elevated, e.g. above 100 ng/L, both assays provide identical information. However, in contrast, only hs-cTn allows a precise differentiation between "normal" and mildly elevated concentrations, thus detects a relevant proportion of patients missed with the conventional assay who have hs-cTn concentrations above the 99th percentile possibly related to AMI. The limit of detection varies among the differnt hs-cTn assays between 1 ng/L and 5 ng/L and the 99th percentile varies among the different hs-cTn assays, mainly being between 10 ng/L and 20 ng/L.   Vishakantha Murthy, PhD, MBA, CCRP and Danni Li, PhD, DABCC, FACB
 


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