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Chemical Pathology

Notes

  • The measurement of troponins is extremely useful in the risk stratification and management planning of patients with acute coronary syndromes and chest pain assessments.
  • The local method is a high sensitivity troponin T assay.
  • See link below for GHNHSFT Troponin guidelines
  • Secondary Care information
  • Primary Care information

Sample requirements

If patient on high dose biotin therapy (>5mg/day) collect sample at least 8 hours after the last dose.

For adults, 5 ml of blood taken into a narrow plain gold top gel tube (or rust top for the Acute Unit).

5ml gold tube

For children and neonates, a minimum of 1 ml taken into a red top plain serum tube.

1ml serum tube

Storage/transport

Store refrigerated if unable to send to the laboratory the same day. Transport as soon as possible at ambient temperature.

Required information

Relevant clinical details including time elapsed between onset of chest pain/symptoms and blood sampling.

Turnaround times

The assays are run throughout the day and night. The in-lab turnaround time is less than 24 hours. The test can be ordered as an urgent request.

Results should normally be available within 1 hour of sample receipt for the acute unit, or within 24 hours for samples received from outside the acute units.

Reference ranges

Cut-offs at 6 hours post Chest Pain:
<14 ng/L Normal Troponin.
14-30 ng/L Indeterminate Troponin: Cannot exclude Acute
Coronary Syndrome: consider ACS in conjunction
with the clinical picture. Repeat at 12 hours
post chest pain to determine if rising or stable
level. Consistent with many non-ischaemic causes
(see http://tinyurl.com/pnek6tl)
>30 ng/L Positive Troponin. Consistent with (but not diagnostic of) Acute Coronary
Syndrome, consider the clinical setting and please refer to http://tinyurl.com/pnek6tl

Further information

To learn more about troponin T visit Lab Tests Online

GHNHSFT Troponin Guideline