The Asia-Pacific Society of Cardiology (APSC) Expert Committee Consensus Recommendations for Assessment of Suspected Acute Coronary Syndrome Using High-Sensitivity Cardiac Troponin T in the Emergency Department

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  • Tan Wei Chieh Jack
    Department of Cardiology, National Heart Centre Singapore Department of Cardiology, Sengkang General Hospital
  • Inoue Kenji
    Department of Cardiology, Juntendo University Nerima Hospital
  • AbdelWareth Laila
    Department of Clinical Pathology, Cleveland Clinic Abu Dhabi
  • Giannitsis Evangelos
    Departments of Cardiology, Angiology and Pulmonology, University Hospital Heidelberg
  • Kasim Sazzli
    UiTM Cardiology
  • Shiozaki Masayuki
    Department of Cardiology, Juntendo University Nerima Hospital
  • Aw Tar Choon
    Department of Laboratory Medicine, Changi General Hospital
  • Cheng Federick
    Heart Institute, St. Luke’s Medical Center
  • Dung Ho Thuong
    Cardiovascular Center and Interventional Cardiology, Thong Nhat Hospital
  • Li Yi-Heng
    Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University
  • Lim Swee Han
    Department of Emergency Medicine, Singapore General Hospital
  • Lukito Antonia Anna
    Department of Cardiology, Siloam Karawaci Hospital
  • Than Martin
    Department of Emergency Medicine, Christchurch Public Hospital
  • Chu Fang-Yeh
    Department of Clinical Pathology, Far Eastern Memorial Hospital Graduate School of Biotechnology and Bioengineering, Yuan Ze University Department of Medical Laboratory Science and Biotechnology, Yuanpei University of Medical Technology
  • Devasia Tom
    Department of Cardiology, Kasturba Medical College, Manipal Academy of Higher Education
  • Lee Chien-Chang
    Department of Emergency Medicine, National Taiwan University Hospital
  • Phrommintikul Arintaya
    Departments of Internal Medicine, Faculty of Medicine, Chiang Mai University
  • Youn Jong-Chan
    Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea
  • Chew Derek P.
    Department of Cardiovascular Medicine, Flinders University

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Abstract

<p>The Asia-Pacific Society of Cardiology (APSC) high-sensitivity troponin T (hs-TnT) consensus recommendations and rapid algorithm were developed to provide guidance for healthcare professionals in the Asia-Pacific region on assessing patients with suspected acute coronary syndrome (ACS) using a hs-TnT assay. Experts from Asia-Pacific convened in 2 meetings to develop evidence-based consensus recommendations and an algorithm for appropriate use of the hs-TnT assay. The Expert Committee defined a cardiac troponin assay as a high-sensitivity assay if the total imprecision is ≤10% at the 99th percentile of the upper reference limit and measurable concentrations below the 99th percentile are attainable with an assay at a concentration value above the assay’s limit of detection for at least 50% of healthy individuals. Recommendations for single-measurement rule-out/rule-in cutoff values, as well as for serial measurements, were also developed. The Expert Committee also adopted similar hs-TnT cutoff values for men and women, recommended serial hs-TnT measurements for special populations, and provided guidance on the use of point-of-care troponin T devices in individuals suspected of ACS. These recommendations should be used in conjunction with all available clinical evidence when making the diagnosis of ACS.</p>

Journal

  • Circulation Journal

    Circulation Journal 84 (2), 136-143, 2020-01-24

    The Japanese Circulation Society

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