Katarína Daňová
The use of high-sensitivity cardiac troponins (hs cTn) assays enabled an early diagnosis and/or exclusion of acute myocardial
infarction. A high analytical sensitivity and accuracy of hs cTn has been achieved at the cost of a reduced diagnostic
specificity compared with the conventional assays (at lower cTn levels – ”chronic” elevations, other acute conditions).
The number of patients with elevated cardiac troponins for various reasons other than myocardial infarction has
increased. There are several strategic tools helping to overcome the ”reduced specificity issue”. These include knowing
the differential diagnosis of cTn elevated concentration, meticulous clinical picture assessment, using serial measurements
with the detection of a rise and/or fall of cardiac troponin levels and absolute delta change, and using rapid rule-
out, rule-in algorithms.