New Testing Platform for Cardiac Markers

Beginning Monday, March 13, 2000 at 7:00 a.m., the Clinical Chemistry Laboratory of the Department of Pathology will institute a new testing platform for cardiac markers. The following markers will be offered CK-MB and Troponin T. The CK-MB test is equivalent to the previous test in terms of sensitivity and specificity except for a change in decision level. The new decision levels for CK-MB are greater than 7.5 ng/mL when the total CK is within the reference range and greater than 2.5 for an index when the total CK is outside the reference range.

Troponin T is equivalent to Troponin I in terms of sensitivity and specificity in detecting cardiac lesions (see ref.). A level of Troponin T greater than 0.1 ng/mL is considered significant.

Sample volumes and tube types remain the same. Pathology requisitions will be revised in the future to reflect this change. For now, an order for Troponin I received after March 13th will receive a Troponin T. Questions may be directed to Dr. Ronald Feld at 6–1759.

1. Hamm CW, et al. Benefit of ABCIXIMAB in patients with refractory unstable angina in relation to serum Troponin T levels. N Engl J Med 1999;340:1623-9.

2. Christenson RH, et al. Cardiac troponin T and cardiac troponin I: relative values in short-term risk stratification of patients with acute coronary syndromes. Clin Chem 1998;44:494-501.

3. Lindahl B, et al. The FRISC experience with troponin T. Use as decision tool and comparison with other prognostic markers. Eur Heart J 1998;19:N51-N58.

4. Porter GA, et al. Troponin T, a predictor of death in chronic haemodialysis patients. Eur Heart J 1998;19:N34-N37

5. Wu AHB, et al. Biochemical differences between cTnT and cTnl and their significance for diagnosis of acute coronary syndromes. Eur Heart J 1998;19:N25-N29.

6. Hetland Ø, et al. Cardiac troponins I and T in patients with suspected acute coronary syndromes: a comparative study in a routine setting. Clin Chem 1998;44:1430-1436.

7. McErlean ES, et al. Comparison of troponin T versus creatine kinase-MB in suspected acute coronary syndromes. Am J Cardiol 2000;85:421-426.