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Our institutional interpretive comments are based on chart reviews and concordance studies that have evolved over time and are fully supported by cardiology. We don't have a time dependent comment. 0.49 or less negative for AMI 0.50 - 1.99 non diagnostic for AMI 2.00 or greater consistent with AMI Any elevation of troponin can be indicative of myocardial injury. DA David Alter, MD Clinical/ Chemical Pathologist Pathology and Laboratory Medicine Spectrum Health - Blodgett 1840 Wealthy ST SE Grand Rapids, MI 49506 616 774 5123 FX 616 774 5280 "...to thine own self be true, And it must follow, as the night the day, Thou canst not then be false to any man..." Shakespeare (Hamlet) "...non tissue laboratory results represent 70 - 80% of the objective data in clinical records and that data contributes 60 - 70% to the critical decisions made in patient care representing only 5% of a health system's cost, but favorably influencing the remaining 95% of cost..." Becich M, Dysert P and Forsman R. "Test results alone don't impact patient care; inappropriate utilization and interpretation can as there are no bad laboratory tests; only outdated and inappropriately utilized ones " DA ________________________________ From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Mohammad Al-Jubouri Sent: Wednesday, November 11, 2009 11:14 AM To: [log in to unmask] Subject: Troponin reporting Dear All, I am trying to refine our troponin I reporting to accomodate the universal definition of acute MI 2007 consensus without creating unnecessary referral workload to cardiology. It would be good if we can reach a consenus on how best to report tropnonins. Therefore, I would be grateful for your critical comments and any additions/omissions that I should make to our report below: Cardiac Troponin I Report TnI + 0.57 ug/L Interpretative guide applies to samples > 12 h post-event. <0.05 No detectable myocardial damage > 0.05 Detectable myocardial damage, the aetiology of which depends on clinical setting and ECG findings Raised TnI can be due to ischaemic cardiac events or non ischaemic cardiac causes such as peri/myocarditis, heart failure & drug cardiotoxicity. It can also be due to non cardiac causes such as pulmonary embolism, critical illness, renal failure, sepsis, stroke & subarachnoid haemorrhage. Many thanks Mohammad Dr. M A Al-Jubouri, MB ChB, MSc, FRCP Edin, FRCPath Consultant Chemical Pathologist ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/