Dr Raphael Twerenbold
Cardiologist, University Hospital Basel, Switzerland

Impact of hs-Tn on Further Cardiac Testing in Suspected AMI Patients


  • Data shows that switching from conventional troponin to high-sensitivity troponin does not increase the use of Coronary Angiography or PCI, and has a >30% reduction in subsequent cardiac stress testing

Transcript of above video:

We investigated the impact of switching from a conventional to a more sensitive cardiac troponin assay in several European hospitals and we were able to present and publish this data in European Heart Journal for more than 2,500 patients. And what we could see is that there was no increase in coronary angiography after switching to a more sensitive essay.

So physicians are often concerned about too many false positives, what they consider it to be. So they are afraid that too many patients will get unnecessary coronary angiography. But rates of coronary angiography and also PCIs remain completely stable during both phases. Of note and we were really surprised to see that, however, there was a substantial reduction of the need of subsequent cardiac stress testing of more than 30%. So obviously since high sensitivity opens a window around the 99th percentile, it gives more information for the clinicians that they can trust on safety of patient presenting with very low levels, so that they do not need, in all cases, subsequent cardiac stress testing. Furthermore, we could also see it was associated with a substantial reduction of duration in the ED, more than 80 minutes, which resulted in total – 20% cost reduction in outpatients.

Updates from Leading Experts

STRONG-HF: Post-discharge Heart Failure Management and Implementation of GDMT Heart Failure Therapy

Prof Alexandre Mebazaa shares the key results and highlights from the STRONG-HF study that assessed the safety, tolerability of optimization of guideline directed medical therapy. [...]


CANVAS study: NT-proBNP and CVD risk reduction

Can you give us a short description of the CANVAS program? The CANVAS program was a set of two trials, whose goal was to evaluate the role of an SGLT2...

1 July 2021
Dr James L Januzzi