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
Journal
Circulation Journal
Journal Volume
84
Journal Issue
2
Pages
136-143
Date Issued
2020
Author(s)
Jack Tan W.C.
Inoue K.
AbdelWareth L.
Giannitsis E.
Kasim S.
Shiozaki M.
Aw T.C.
Cheng F.
Dung H.T.
Li Y.-H.
Lim S.H.
Lukito A.A.
Than M.
Chu F.-Y.
Devasia T.
Phrommintikul A.
Youn J.-C.
Chew D.P.
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. ? 2020 Japanese Circulation Society. All rights reserved.
SDGs
Other Subjects
troponin T; biological marker; troponin T; acute coronary syndrome; advisory committee; algorithm; Asia Pacific Society of Cardiology; clinical assessment; computed tomographic angiography; consensus; coronary angiography; diagnostic accuracy; disease assessment; electrocardiogram; emergency ward; enzyme assay; enzyme blood level; health care personnel; heart infarction; heart muscle injury; heart muscle ischemia; high sensitivity troponin t assay; hospital mortality; human; limit of detection; medical society; mortality; non ST segment elevation myocardial infarction; percutaneous coronary intervention; point of care testing; predictive value; Review; risk assessment; sensitivity analysis; sensitivity and specificity; ST segment elevation myocardial infarction; acute coronary syndrome; blood; cardiology; cardiology service; cardiovascular system examination; decision support system; decision tree; hospital emergency service; practice guideline; prognosis; reproducibility; upregulation; Acute Coronary Syndrome; Algorithms; Biomarkers; Cardiology; Cardiology Service, Hospital; Consensus; Decision Support Techniques; Decision Trees; Diagnostic Techniques, Cardiovascular; Emergency Service, Hospital; Humans; Predictive Value of Tests; Prognosis; Reproducibility of Results; Societies, Medical; Troponin T; Up-Regulation
Type
Review