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High-Sensitivity Cardiac Troponin Assay in Patients With Kidney Impairment

High-Sensitivity Cardiac Troponin Assay in Patients With Kidney Impairment Letters Invited Commentary this high-risk population, but the lower specificity of hs-cTn test- High-Sensitivity Cardiac Troponin Assay ing compared with conventional troponin assays for all popu- in Patients With Kidney Impairment: lations has the potential to trigger unnecessary stress tests, an- A Challenge to Clinical Implementation giograms, coronary revascularization procedures, and High-sensitivity cardiac troponin (hs-cTn) assay was ap- admissions for all patients, and this potential is particularly high proved by the US Food and Drug Administration in 2017, and in the population with kidney impairment. Despite these chal- its appropriate use is currently being investigated. In this lenges, it is not operationally feasible to use different troponin issue of JAMA Internal Medicine, Gallacher et al examine the assays (conventional vs high sensitivity) for different patient use of hs-cTn assays in pa- populations; therefore, this topic is pressing. tients with kidney impair- The hope for hs-cTn assays was both to enable earlier di- Related article ment in a prespecified second- agnosis of acute MI (type 1) than by conventional troponin ary analysis of a randomized assays and to reduce costs and improve efficiency by allow- clinical trial of patients with suspected acute coronary syn- ing more rapid discharge of low-risk http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

High-Sensitivity Cardiac Troponin Assay in Patients With Kidney Impairment

JAMA Internal Medicine , Volume 181 (9) – Sep 7, 2021

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Publisher
American Medical Association
Copyright
Copyright 2021 American Medical Association. All Rights Reserved.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/jamainternmed.2021.1194
Publisher site
See Article on Publisher Site

Abstract

Letters Invited Commentary this high-risk population, but the lower specificity of hs-cTn test- High-Sensitivity Cardiac Troponin Assay ing compared with conventional troponin assays for all popu- in Patients With Kidney Impairment: lations has the potential to trigger unnecessary stress tests, an- A Challenge to Clinical Implementation giograms, coronary revascularization procedures, and High-sensitivity cardiac troponin (hs-cTn) assay was ap- admissions for all patients, and this potential is particularly high proved by the US Food and Drug Administration in 2017, and in the population with kidney impairment. Despite these chal- its appropriate use is currently being investigated. In this lenges, it is not operationally feasible to use different troponin issue of JAMA Internal Medicine, Gallacher et al examine the assays (conventional vs high sensitivity) for different patient use of hs-cTn assays in pa- populations; therefore, this topic is pressing. tients with kidney impair- The hope for hs-cTn assays was both to enable earlier di- Related article ment in a prespecified second- agnosis of acute MI (type 1) than by conventional troponin ary analysis of a randomized assays and to reduce costs and improve efficiency by allow- clinical trial of patients with suspected acute coronary syn- ing more rapid discharge of low-risk

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Sep 7, 2021

References