Troponin T, High Sensitivity
| Label Mnemonic: | TROPTHS |
| Epic code: | LAB9092 |
| Downtime form: | A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery |
Chemistry
6240 RCP
356-3527
6240 RCP
356-3527
Specimen(s):
Plasma
Collection Medium:
 |
| Plasma Separator Tube 4.5 mL |
Minimum:
3 mL; plasma separator tube top or TWO Microtainer®
devices.
Testing Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around
Time:
Results available within 1 hour of specimen receipt in laboratory.
Reference Range:
Age Males Females 0 months -<6 months =<93 ng/L =<93 ng/L 6 months – <1 year =<21 ng/L =<21 ng/L 1 years – <19 years =<14 ng/L =<11 ng/L 19 years+ =<22 ng/L =<14 ng/L Clinically significant value >100 ng/L (outpatient only, excluding Emergency Department).
Comments:
The University of Iowa Hospitals & Clinics converted to the high-sensitivity troponin T assay on 3/9/2021.
According to the Fourth Universal Definition of Myocardial Infarction, high-sensitivity cardiac troponin assays are recommended for routine clinical use. Elevations in high-sensitivity cardiac troponin above the upper 99th percentile limit are sensitive for myocardial injury. Myocardial injury may be due to acute myocardial ischemia or other causes (e.g., myocarditis, heart failure, sepsis, chronic kidney disease, pulmonary embolism, strenuous exercise). For diagnostic purposes, the troponin T findings should always be assessed in conjunction with the patient's medical history, clinical examination and other findings.
This test is also performed in the Iowa River Landing (IRL) clinical laboratory (for specimens drawn at that site).
References:
1. Turner KA, et al. Evaluating Tiered Hemolysis Thresholds to Facilitate Rapid Reporting of High-Sensitivity Cardiac Troponin. J Appl Lab Med. 2019 Sep;4(2):193-200.
2. Bohn MK, et al. High-Sensitivity Generation 5 Cardiac Troponin T Sex- and Age-Specific 99th Percentiles in the CALIPER Cohort of Healthy Children and Adolescents. Clin Chem. 2019 Apr;65(4):589-591.
3. Thygesen K, et al. Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018 Nov 13;138(20):e618-e651.
4. Sandoval Y, Jaffe AS. Using High-Sensitivity Cardiac Troponin T for Acute Cardiac Care. Am J Med. 2017 Dec;130(12):1358-1365.e1.
5. Januzzi JL Jr, et al. Recommendations for Institutions Transitioning to High-Sensitivity Troponin Testing: JACC Scientific Expert Panel. J Am Coll Cardiol. 2019 Mar 12;73(9):1059-1077.
6. Sandoval Y, et al. Implementing High-Sensitivity Cardiac Troponin T in a US Regional Healthcare System. Circulation. 2020 Jun 9;141(23):1937-1939.
A protocol for the use of high-sensitivity cardiac troponin T in the evaluation of patients with acute chest pain was developed via collaboration between Emergency Medicine, Cardiology, Hospitalist, and Pathology teams.
According to the Fourth Universal Definition of Myocardial Infarction, high-sensitivity cardiac troponin assays are recommended for routine clinical use. Elevations in high-sensitivity cardiac troponin above the upper 99th percentile limit are sensitive for myocardial injury. Myocardial injury may be due to acute myocardial ischemia or other causes (e.g., myocarditis, heart failure, sepsis, chronic kidney disease, pulmonary embolism, strenuous exercise). For diagnostic purposes, the troponin T findings should always be assessed in conjunction with the patient's medical history, clinical examination and other findings.
This test is also performed in the Iowa River Landing (IRL) clinical laboratory (for specimens drawn at that site).
References:
1. Turner KA, et al. Evaluating Tiered Hemolysis Thresholds to Facilitate Rapid Reporting of High-Sensitivity Cardiac Troponin. J Appl Lab Med. 2019 Sep;4(2):193-200.
2. Bohn MK, et al. High-Sensitivity Generation 5 Cardiac Troponin T Sex- and Age-Specific 99th Percentiles in the CALIPER Cohort of Healthy Children and Adolescents. Clin Chem. 2019 Apr;65(4):589-591.
3. Thygesen K, et al. Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018 Nov 13;138(20):e618-e651.
4. Sandoval Y, Jaffe AS. Using High-Sensitivity Cardiac Troponin T for Acute Cardiac Care. Am J Med. 2017 Dec;130(12):1358-1365.e1.
5. Januzzi JL Jr, et al. Recommendations for Institutions Transitioning to High-Sensitivity Troponin Testing: JACC Scientific Expert Panel. J Am Coll Cardiol. 2019 Mar 12;73(9):1059-1077.
6. Sandoval Y, et al. Implementing High-Sensitivity Cardiac Troponin T in a US Regional Healthcare System. Circulation. 2020 Jun 9;141(23):1937-1939.
A protocol for the use of high-sensitivity cardiac troponin T in the evaluation of patients with acute chest pain was developed via collaboration between Emergency Medicine, Cardiology, Hospitalist, and Pathology teams.
Test
Limitations:
The assay is unaffected by icterus (bilirubin is less than 25
mg/dL), lipemia (Intralipid is less than 1500 mg/dL) and biotin is less than 20 ng/mL (criterion: recovery within 1.4 ng/L or 10% of initial value).
Hemolysis leads to decreased troponin T concentrations. Troponin T will not be reported for specimens with severe enough hemolysis (135 – 300 mg/dL hemoglobin depending on troponin T concentration).
Results from this assay may be falsely decreased in patients taking high-dose biotin (>5 mg) within 12 hours of specimen collection.
Hemolysis leads to decreased troponin T concentrations. Troponin T will not be reported for specimens with severe enough hemolysis (135 – 300 mg/dL hemoglobin depending on troponin T concentration).
Results from this assay may be falsely decreased in patients taking high-dose biotin (>5 mg) within 12 hours of specimen collection.
Methodology:
Electrochemiluminescence Immunoassay
CPT Code:
84484