Dr Raphael Twerenbold
Cardiologist, University Hospital Basel, Switzerland

How hs-TnT Made a Difference – Dr Twerenbold’s Story


  • High-sensitivity troponin provides more benefits and higher safety as compared with conventional troponin, for better accuracy in diagnosis of small myocardial injury

Transcript of above video:

We’ve had the patient presenting to the ED, at the age of 45 with acute chest pain to the ED, but we’re still using conventional less sensitive cardiac troponin assays. So as standard of care, we had the ECG recorded in this patient, showing no ischemia signs at all. So we also had the cardiac biomarkers tested, so CK,CK-MB, conventional troponin, and we’re glad to see that they are all with the normal limits. So as standard of care we have tested once again after six hours, and again everything was within normal limits.

So patient was pain free at the time of presentation to the ED and we’ve sent him home and wanted to have him come back through the hospital for cardiac stress testing a few days later. And so he did, but he came a bit earlier, presented with acute chest pain again.

As always, we also recorded the ECG once again. All of a sudden, we could detect ST-elevation myocardial infarction with a completely occluded coronary artery. We were obviously terribly wrong in sending this patient home a few days ago, but we were glad because the patient was enrolled in observational trial so we could go back and see in the serial samples that we have taken from him at the first time he presented to the ED. And could determine more sensitive cardiac troponin assays in these first samples and could see that all of them would have been elevated, already at the time of his first visit. So we missed small acute myocardial infarction four days ago, that we would have detected using more sensitive assays, so there’s definitely substantial increase in safety and benefit for the patient using more sensitive assays.

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