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High-sensitivity troponin test comes to Asante
The test comes with some changes you’ll need to know.
Asante is moving to a new troponin I, high-sensitivity test (hsTnI) which goes live on Feb. 28. This new high-sensitivity test replaces the previous troponin I test throughout Asante.
With this, there are important changes you need to know.
The new assay is more sensitive to detection of myocardial injury.
![troponin](https://news.asante.org/wp-content/uploads/2023/02/troponin.png)
There are two types of orders for the hsTn1 test:
- Two-hour protocol: Used for new-onset symptoms of acute coronary syndrome. It includes an initial troponin draw and then a two-hour follow-up draw.
- Stand-alone troponin test: Used for subsequent tests or troponin testing that does not require a two-hour protocol.
New critical values and reporting:
- Please note the unit of measure change (ng/mL to ng/L).
- A new reporting consideration is the delta value. The delta value is a change between two values.
- The delta value is used with the two-hour protocol. Delta increases can alert providers that the patient may be on the trajectory toward acute myocardial infarction (AMI).
- If the second hsTnI at the two-hour mark increases by > 20 ng/L, it is considered a critical value.
- Lab will notify the nurse of the delta value increase.
Important points on interpreting hsTnI results:
- A single hsTnI result often cannot be used alone for clinical decisions.
- Abnormal values (> 18ng/L) do not always indicate AMI.
- An elevated hsTnI can be associated with other conditions causing cardiac injury. Providers should evaluate all possible causes and the delta value.
- The two-hour hsTnI values are important because a percentage of AMI patients will have an initial hsTnI result that is normal (0-18 ng/L).
In summary:
- Remember the new units of measure (ng/L), new abnormal value (>18ng/L) and new critical values (>100 ng/L and/or delta change of >20 ng/L).
- There are two orders for this test: the two-hour protocol and a stand-alone protocol.
For questions about the new hsTnI laboratory test, reach out to:
- Jamey Licata, ARRMC Lab chemistry technical specialist, (541) 789-4175.
- Jessica Lambert, ATRMC Lab chemistry technical specialist, (541) 472-7181.
- Tom Arnold, AACH Lab supervisor, (541) 201-4047.
If you have a question, please contact the author or relevant department directly.