0 hour baseline high sensitivity TNI test collection (Troponin I 0Hr)
2 hour post baseline high sensitivity TNI test collection (Troponin I 2Hr)
Exclusion diagnosis of acute myocardial infarction.
At the time of baseline TNI collection, phlebotomist will update the 2 hour TNI collection date/time information to be 2 hours post baseline date/time of collection.
Serum specimens exposed to repeated freeze/thaw cycles.
High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay.
Heterophile Antibodies and Rheumatoid factor can react with reagent immunoglobulins. Human anti-mouse antibodies may cause falsely low or high results. Troponin autoantibodies may interfere.
-If results do not fall into above, then observe. Getting additional draws (e.g. at 4 hours) may be helpful.
Cardiac Troponin I (cTnI) is very specific to myocardium and not expressed during any developmental stage in skeletal muscle. Increased levels of cTnI are detected with myocardial injury. Detection of rise and/or fall of cTnI are essential to establish the diagnosis of acute myocardial infarction (MI). An increased cTnI concentration is defined as a value exceeding the upper reference limit of the 99th percentile of a normal reference population and is designated as the decision limit for the diagnosis of acute MI (Third Universal definition of Myocardial infarction, ESC/ACCF/AHA/WHF Expert consensus document. Circulation 2012; 126: 2020). Demonstration of rising and/or falling pattern is required to distinguish acute from elevations of cTnI levels that are associated with chronic heart diseases.
A positive cTnI result therefore, is not always indicative of ischemia. Other conditions resulting in myocardial cell damage can contribute to elevated cTnI include, but are not limited to:
Elevated Tnl Values in Patients Without AMICardiac conditions• Angina/Unstable Angina• Atrial fibrillation• Cardiac surgery• Cardiomyopathy• Congestive heart failure• Coronary artery disease• Heart failure• Hypertensive urgency• Myocarditis• Pericarditis• Pulmonary emoblism• Recent cardiac intervention• Severe valvular heart disease• Tachycardia
Elevated Tnl Values in Patients Without AMI
• Angina/Unstable Angina
• Atrial fibrillation
• Cardiac surgery
• Congestive heart failure
• Coronary artery disease
• Heart failure
• Hypertensive urgency
• Pulmonary emoblism
• Recent cardiac intervention
• Severe valvular heart disease
• Chronic lung disease
• Cardiac contusion related to a traumatic injury• Renal failure• Pneumonia• Pulmonary embolism For assessing acute MI, blood samples should be drawn at the time of admission and repeated at 3 to 6 hours intervals. On certain occasions additional samples between 12 and 24 hours may be required if earlier measurements are not elevated and clinical suspicion is high for MI.
• Cardiac contusion related to a traumatic injury
• Renal failure
• Pulmonary embolism
For assessing acute MI, blood samples should be drawn at the time of admission and repeated at 3 to 6 hours intervals. On certain occasions additional samples between 12 and 24 hours may be required if earlier measurements are not elevated and clinical suspicion is high for MI.