Extract

Cardiac troponin is a cardiospecific protein that is detectable in the blood of patients with myocardial injury with sensitive and specific assays (1). Cardiac troponin is recommended as the preferred biomarker for the diagnosis of myocardial infarction (MI),2 for risk stratification, and for therapeutic guidance regarding anticoagulation therapy and invasive management (2–4). Assays should be appropriately precise to measure at the 99th-percentile value with a total imprecision of ≤10%. Until recently, assays were insufficiently precise, and rather than using the recommended 99th-percentile value, many clinicians had advocated the use of the lowest value at which an assay achieved a 10% CV as the decision cutoff. Manufacturers have refined their assays through improvements in reagent or antibody configuration, changes in the microparticle capture bed, introduction of a third antibody, increases in sample volume, and other modifications (5). For these reasons, newer generations of cardiac troponin assays now provide improved analytical sensitivity and precision.

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