Surveys on the use of cardiac markers in the UK

Abstract

Finance, staffing and equipment constraints may offer significant impediments to troponin testing with a 1-h turnaround time.

Evaluation of Imprecision for Cardiac Troponin Assays at Low-Range Concentrations

“…National and international scientific organizations have suggested the use of these markers when implementing new diagnostic strategies in patients with acute coronary syndrome (1)(2)(3)(4). As a result, increasing numbers of clinical laboratories are in the process of switching to these new markers, and more physicians can be expected to rely increasingly, or solely, on cardiac troponin measurements when myocardial infarction (MI) 9 is suspected on clinical grounds (5)(6)(7)(8)(9). In particular, the Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction has recommended that an increased concentration of cardiac troponin be defined as a measurement exceeding the 99th percentile of the distribution of cardiac troponin concentrations in the reference group, a very low threshold (3 ).…”

The new definition of myocardial infarction and the impact of troponin determination on clinical practice

“…Given the evident importance of the new MI definition in determining the management strategy and providing prognostic advice for the patient, it is rather surprising that recent surveys indicate that many clinicians have not yet taken on board the new recommendations [20,[31][32][33]. In general, the trend to change to the new definition of MI seems to be occurring earlier in the United States than in European countries [20,34].…”

“…In general, the trend to change to the new definition of MI seems to be occurring earlier in the United States than in European countries [20,34]. Little use of troponin as diagnostic testing has been reported in Spain, the U.K., and Eastern European countries [31][32][33]. It is not completely clear why clinicians are not using the new MI definition more widely [35].…”