REVIEW – September 2016

Evaluation of serum troponin measurement in acute medicine

Authors: Karl Kiisk, Kuido Nõmm, Eno-Martin Lotman, Peep Talving, Joel Starkopf

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Serum troponin (Tn) measurement is widely used in emergency department for diagnosing and excluding acute coronary syndromes. There are Tn assays which are highly sensitive (hs-cTn) and capable of detecting minimal concentrations of Tn in blood serum. Higher sensitivity causes a decrease in specificity. It is not uncommon to detect Tn values reaching higher than 99th percentile in patients who do not have symptoms specific to acute or chronic heart disease. There are several medical conditions where troponin elevation might be detectable in hs-cTn assays. Troponin elevation in these instances might have a prognostic value and might be helpful for managing the patient. To evaluate the prognostic value of Tn levels in non-cardiac patients in emergency department warrants further prospective investigations.