Use of the high-sensitivity troponin assays in the evaluation of patients with chest pain a consensus document from the working group on troponin of the lebanese society of cardiology

Abstract

Chest pain is a common clinical presentation, especially in the emergency department. Both rapid identification of patients with myocardial infarction, as well as those with non-cardiac chest pain, are important in order to start therapy in the former and avoid unnecessary investigations and delay in discharge in the latter. Beside EKG, cardiac biomarkers are a key element in decision making. Conventional creatinine kinase and troponin assays are not sensitive enough and have to be repeated at least 6 to 12 hours after initial evaluation. New high-sensitivity troponin tests are currently available and if used appropriately can substantially improve management of these patients. Because the analytical characteristics and protocol of use of these high-sensitivity assays may not be well understood by the medical community, the Lebanese Society of Cardiology created a working group charged with the mission of writing a concise and easy to read document addressing this important topic. This manuscript reviews the most important characteristics of hs-sensitivity troponin assays and the algorithms in which they should be used in patients with chest pain. The objective is to provide to Lebanese physicians evidence-based recommendations to rapidly rule-in or rule-out myocardial infarction in patients with chest pain. © 2020 Lebanese Order of Physicians. All rights reserved.