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Aiding in the exclusion of the diagnosis of acute coronary syndrome in a single plasma specimen
Aiding in the diagnosis of acute coronary syndrome
Monitoring acute coronary syndromes and estimating prognosis
Possible utility in monitoring patients with nonischemic causes of cardiac injury
1. Lithium heparin gel tubes should be centrifuged within 2 hours of collection.
2. Plasma from lithium heparin tubes should be centrifuged and aliquoted into a plastic vial within 2 hours of collection.
As with all markers of cardiac injury, elevations of cardiac troponin T (cTnT) do not in and of themselves indicate the presence of an ischemic mechanism. Many other disease states can be associated with elevations of cTnT via mechanisms different from those that cause injury in patients with acute coronary syndromes. These include trauma including contusion, ablation, and pacing; congestive heart failure; pulmonary embolism; kidney failure; and myocarditis.
Males: < or =15 ng/L
Females: < or =10 ng/L
Values for healthy adults, based upon available literature and clinical guidelines, are 10 ng/L or less for women and 15 ng/L or less for men.
For patients who present with suspected acute coronary syndromes, troponin T values greater than the reference interval with a rising (> or =10 ng/L over 2 hours or > or =12 ng/L over 6 hours) pattern are highly suggestive of acute cardiac injury. Decreasing values are indicative of recent cardiac injury. Serial measurement is highly recommended for the diagnosis or exclusion of acute coronary syndromes.
Troponin T values greater than the reference interval are associated with adverse events in patients with ischemic heart disease and many other clinical situations. Clinical judgment is necessary to distinguish patients who have ischemic heart disease from those who do not.