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Test Code LAB5997 High Sensitivity Troponin I, plasma

Performing Laboratory

Barnes-Jewish Hospital Laboratory

Methodology

Chemiluminescent microparticle immunoassay

Literature Reference:

Package insert: STAT High Sensitivity Troponin-I reagent. Abbott Laboratories, Diagnostic Division, Abbott Park, IL

Specimen Requirements

Specimen Type: Plasma
Container/Tube: Lavender top (K2 EDTA)
Specimen Volume: Full tube


Additional Information: Troponin I concentrations increase in blood ~2 hours after myocardial infarction and remain elevated for up to 8 days. Patients with chronic comorbidities that cause non-ischemic cardiac injury (e.g., cardiomyopathy, end-stage renal failure, etc.) will often have elevated high sensitivity troponin concentrations. According to the 4th Universal Definition of Myocardial Infarction, the following criteria must be met for a myocardial infarction to be present: “clinical evidence of acute myocardial ischemia and with detection of a rise and/or fall of troponin values with at least one value above the 99th percentile URL.” Therefore, serial troponin testing is essential for diagnosing acute MI, particularly when index troponin concentrations are above the sex specific 99th% upper reference limit but < 100 ng/L. Significant changes (delta) in troponin concentrations can be found in the acute chest pain algorithm adopted by WU lab medicine, cardiology and emergency medicine at https://bjhlab.testcatalog.org/show/hsTrop-1.

Literature Reference:

Journal of the American college of Cardiology 2019;73:1059-1077.

Day(s) Test Set Up

Monday through Sunday
Turnaround Time:
STAT: 1 hour after receipt in laboratory
Routine: not available

Reference Values

Male: < 35 ng/L

Female: < 17 ng/L

Critical result (automatic call-back): > 200 ng/L or Significant Delta for 2, 4, or 6 Hr sample
Note: Initial critical result is called. Subsequent values within 48 hours are not called but these values will be modified with comment “Previous critical result noted.”

Literature References:

Thygesen K, Alpect JS, Jaffe AS, et.al. Fourth Universal Definition of Myocardial Infarction. J Am Coll Cardiol 2018;72:2231-2264.

Specimen Transport Temperature

Ambient

Additional Information

For BJH Laboratory Use Only

Alternate Tube(s):

None

Laboratory Processing Instructions:

Test performed in BJH Core Lab.  Processed by automated line for delivery to the Architect off-line analyzer.  Completed specimens are stored refrigerated for 5 days. 

Add-on testing is not allowed.   Exceptions are allowed for 7CAM, SCCSC Lab, or on approval by supervisor or LMR for other outpatient locations only.

Test Classifications and CPT Coding

84484-Troponin I

80061-Lipid panel (if appropriate)

Specials Instructions

See Analyte Stability Chart under General Information for a complete list.

LOINC Code Information

Name

LOINC Code

Troponin I High Sensitivity, Plasma

89579-7