A consensus meeting was held during the summer on hsTnT in Manchester, with a follow up meeting in Cardiff. The outcome is reported in Novembers ACB News
http://www.acb.org.uk/site/acbnews.asp
Regards
Martin
Summary of consensus was:
1.Reporting units for hsTnT should be ng/L.
2.Results should be reported down to the limit of the blank (3 ng/L)
3.Two measurements of hsTnT are required in the assessment of patients with chest pain.
4.The second sample should be measured 6-9 hours after presentation. However if the second sample does not show an incremental rise yet clinical suspicion remains then a further sample should be taken at 12 hours after presentation.
5. There was significant debate regarding what constitutes a significant increase in the second sample. Biological and analytical variation needs to be taken into account. The group agreed that there should be three decision categories:
Category a: Less than 20% change: not consistent with an acute event
Category b: 20-100% change: Significant rise in hsTnT, suggest further evaluation to distinguish between acute causes and chronic elevation in hsTnT (but with one sample above 14 ng/L)
Category c: Greater than 100% change: consistent with myocardial infarction (but with one sample above 14 ng/L)
6. Patients with chronically elevated hsTnT (>14ng/L) are at risk of future cardiac events and should be followed up.
7. No conclusion was reached on what single level of hsTnT could be used to diagnose an MI and further work on this is required.
The consensus was based on the evaluation of current data in order to recommend a unified approach in the biochemical evaluation of chest pain. It is recognised that as evidence accumulates, practices may change accordingly. However a consensus approach is preferable to multiple local practices.
________________________________
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Mainwaring-Burton Richard (South London Healthcare NHS Trust)
Sent: 26 November 2010 11:23
To: [log in to unmask]
Subject: Reporting Troponin T
G'day all
With the availability of the 'ultra' sensitive Troponin T assays, what are punters views on reporting units ?
"Traditional" units are µg/L, but that now means reporting in 3 decimal places.
Have many folks changed to ng/L resulting in whole numbers.
Will report back consensus if one exists. Should this be done fomally by the EQAS schemes ?
with best wishes
Richard
Richard Mainwaring-Burton
Consultant Biochemist
South London Healthcare Trust
Queen Mary's Hospital
Sidcup, Kent, DA14 6LT
020-8308-3084
mob: 07831-739876
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