Proposal for the use in emergency departments of cardiac troponins measured with the latest generation methods in patients with suspected acute coronary syndrome without persistent ST-segment elevation

Abstract

The purpose of this document is to develop recommendations on the use of the latest generation of cardiac troponins in emergency room settings for the diagnosis of myocardial infarction in patients with suspected acute coronary syndrome without persistent ST-segment elevation (NSTE-ACS). The main points which have been addressed reaching a consensus are: i) suitability and appropriateness of the terminology; ii) appropriateness of the request; iii) confirmation of the diagnosis of myocardial infarction (rule-in); iv) exclusion of the diagnosis of myocardial infarction (rule-out). Each point has been analyzed by taking into account the evidence presented in medical publications. Recommendations were developed using the criteria adopted by the European Society of Cardiology and the American Heart Association/American College of Cardiology. Each point of the recommendation was submitted for validation to an external audit by a Group of Experts (named above).

Keywords

• acute coronary syndrome, cardiac troponin, emergency department, high-sensitivity assays, non-ST-segment elevation