Discordance of troponin assays in patients with acute coronary syndromes

The US Food and Drug Administration (FDA) has recently approved three high-sensitivity cardiac troponin assays (hs-cTn) for clinical use in the United States of America.

“There is no known concordance between the three assays. In our study we used all three hs-cTN assays to measure the troponin level in blood samples of patients with acute chest pain requiring emergency triage”, said dr. Júlia Karády, first author and PhD student at Semmelweis University.

Based on the troponin level measurements taken at the same time, only 37.4% of all the blood samples were classified into the same analytical benchmark category by the three assays. In the subgroup analysis of 242 patients, the measurement of troponin levels was performed on serial samples and the three assays suggested the same clinical diagnosis in 74.8% of the cases.

It is important to draw the attention of clinicians to the significant differences between hs-cTn assays in clinical use, which is particularly important when patients are transferred from one hospital to the other and the two institutions use different types of hs-cTn assays.