The Asia-Pacific Society of Cardiology (APSC) Expert Committee Consensus Recommendations for Assessment of Suspected Acute Coronary Syndrome Using High-Sensitivity Cardiac Troponin T in the Emergency Department

Circ J. 2020 Jan 24;84(2):136-143. doi: 10.1253/circj.CJ-19-0874. Epub 2019 Dec 18.

Abstract

The Asia-Pacific Society of Cardiology (APSC) high-sensitivity troponin T (hs-TnT) consensus recommendations and rapid algorithm were developed to provide guidance for healthcare professionals in the Asia-Pacific region on assessing patients with suspected acute coronary syndrome (ACS) using a hs-TnT assay. Experts from Asia-Pacific convened in 2 meetings to develop evidence-based consensus recommendations and an algorithm for appropriate use of the hs-TnT assay. The Expert Committee defined a cardiac troponin assay as a high-sensitivity assay if the total imprecision is ≤10% at the 99th percentile of the upper reference limit and measurable concentrations below the 99th percentile are attainable with an assay at a concentration value above the assay's limit of detection for at least 50% of healthy individuals. Recommendations for single-measurement rule-out/rule-in cutoff values, as well as for serial measurements, were also developed. The Expert Committee also adopted similar hs-TnT cutoff values for men and women, recommended serial hs-TnT measurements for special populations, and provided guidance on the use of point-of-care troponin T devices in individuals suspected of ACS. These recommendations should be used in conjunction with all available clinical evidence when making the diagnosis of ACS.

Keywords: Acute coronary syndrome; Asia-Pacific; Consensus recommendations; High-sensitivity troponin T.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Acute Coronary Syndrome / blood
  • Acute Coronary Syndrome / diagnosis*
  • Acute Coronary Syndrome / therapy
  • Algorithms
  • Biomarkers / blood
  • Cardiology / standards*
  • Cardiology Service, Hospital / standards*
  • Consensus
  • Decision Support Techniques
  • Decision Trees
  • Diagnostic Techniques, Cardiovascular / standards*
  • Emergency Service, Hospital / standards*
  • Humans
  • Predictive Value of Tests
  • Prognosis
  • Reproducibility of Results
  • Societies, Medical
  • Troponin T / blood*
  • Up-Regulation

Substances

  • Biomarkers
  • Troponin T