Pre-analytical factors and analytical issues affecting interpretation of cardiovascular biomarkers

Abstract

The Universal Definition of Myocardial Infarction globally endorses cardiac troponin (T and I; cTnT, cTnI) as the biomarker of choice for the diagnosis and assessment of acute coronary syndrome (ACS) and should be utilized routinely in patients with symptoms suggestive of acute myocardial infarction (AMI) [1]. Despite the widespread use of troponin in clinical practice there remain a number of pre-analytical, analytical and interpretive issues which can confound clinical interpretation and will likely be magnified with high-sensitivity troponin assays. The following case studies and discussion highlight some of these issues and nuances associated with troponin assays.