Rajiv Gulati, MD: Greetings. I'm Dr Rajiv Gulati, a cardiologist at Mayo Clinic in Rochester, Minnesota, and today I'm joined by Dr Allan Jaffe, who is a well-known expert in the field of biomarkers and heart disease. Today we'll be discussing high-sensitivity troponin assays and how we use them or how we will be using them. Welcome, Allan.
Allan Jaffe, MD: Pleasure to be here with you.
Dr Gulati: Allen, perhaps we can start by outlining: what is high-sensitivity troponin?
Dr Jaffe: There's a fair amount of confusion. Clearly, we're developing assays that are more and more sensitive. What has been proposed as the metric to use, albeit relatively arbitrarily, is that high-sensitivity assays should detect values in a large number of normal individuals—at least 50%. That's chosen as a surrogate for clinical sensitivity.
The problem with that is that some assays, [such as] the Roche high-sensitivity assay, do not meet that [standard] in [many] evaluations and yet clinically seem to have a lot more sensitivity for the detection of disease. So there is some degree of arbitrariness there, but most of the very high-sensitivity assays detect values in 80% to 100% of people, so it is very likely that those assays are substantially more sensitive.
Pathology of Acute Myocardial Infarction
Postinfarction Ventricular Septal Rupture
Complications of Myocardial Infarction
COMMENTARY
Get Ready For High-Sensitivity Troponin Assays
Allan Jaffe, MD; Rajiv Gulati, MD, PhD
DisclosuresDecember 08, 2016
Editorial Collaboration
Medscape &
Rajiv Gulati, MD: Greetings. I'm Dr Rajiv Gulati, a cardiologist at Mayo Clinic in Rochester, Minnesota, and today I'm joined by Dr Allan Jaffe, who is a well-known expert in the field of biomarkers and heart disease. Today we'll be discussing high-sensitivity troponin assays and how we use them or how we will be using them. Welcome, Allan.
Allan Jaffe, MD: Pleasure to be here with you.
Dr Gulati: Allen, perhaps we can start by outlining: what is high-sensitivity troponin?
Dr Jaffe: There's a fair amount of confusion. Clearly, we're developing assays that are more and more sensitive. What has been proposed as the metric to use, albeit relatively arbitrarily, is that high-sensitivity assays should detect values in a large number of normal individuals—at least 50%. That's chosen as a surrogate for clinical sensitivity.
The problem with that is that some assays, [such as] the Roche high-sensitivity assay, do not meet that [standard] in [many] evaluations and yet clinically seem to have a lot more sensitivity for the detection of disease. So there is some degree of arbitrariness there, but most of the very high-sensitivity assays detect values in 80% to 100% of people, so it is very likely that those assays are substantially more sensitive.
© 2016 Mayo Clinic
Cite this: Get Ready For High-Sensitivity Troponin Assays - Medscape - Dec 08, 2016.
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Authors and Disclosures
Authors and Disclosures
Authors
Allan Jaffe, MD
Professor, Pathology and Laboratory Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota
Disclosure: Allan Jaffe, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Abbott Laboratories, Beckman-Coulter, Alere, Critical Diagnostics, Radiometer, Trinity, ET Healthcare, Ortho Diagnostics, Amgen, Roche, LPATH, Novartis
Rajiv Gulati, MD, PhD
Associate Professor of Medicine, College of Medicine, Consultant, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
Disclosure: Rajiv Gulati, MD, PhD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: PPD Development, Cardiovascular Research Foundation, InspireMD, Boston Scientific, Baxter Healthcare, Medtronic, TEVA Pharmaceuticals, St Jude Medical