Summary of webinar by released by Washington University and Barnes Jewish Hospitals httpsvimeocom440814898 Benefits of high sensitivity troponin Measures the same cardiac specific troponin molecule as conventional assay but can detect at levels 10 fold lower better sensitivity ID: 1038106
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1. High sensitivity cardiac troponin assaySummary of webinar by released by Washington University and Barnes Jewish Hospitals https://vimeo.com/440814898
2. Benefits of high sensitivity troponin Measures the same cardiac specific troponin molecule as conventional assay, but can detect at levels 10 fold lower (better sensitivity)Increased precision, <10% variability (better reproducibility)Expedited diagnostic work up with rapid rule out protocols, shorter ER length of stay
3. New unitsConventional troponin ng/mLHS troponin ng/LGender specific cutoffs for normalGoal: whole integer values without confusing decimals
4. Myocardial infarctionElevated troponin = myocardial injuryAcute injury = rise / fall of troponin Chronic myocardial injury = elevated but static level of troponinAcute myocardial infarction = acute injury + evidence of ischemiaType I vs Type II MISymptoms of ischemiaNew ischemic ECG changesPathological Q wavesNew loss of viable myocardium on imaging (new wall motion abnormality)Coronary thrombus by angiographyRise / fall of troponin
5. Myocardial injury without ischemiaCardiac contusionAblationPacing, defibrillationMyocarditisRhabdomyolysisCardiotoxic agentsRenal failureCardiomyopathySepsisPulmonary hypertensionExerciseAcute stroke or SAH
6. Troponin Elevation Magnitude JACC 2019; 73:1059-77
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9. Delta troponin