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Am Fam Physician. 2024;110(4):425-427

Author disclosure: No relevant financial relationships.

TestIndicationPopulation* Cost
High-sensitivity cardiac troponin assayRuling in or out acute coronary syndromePatients presenting to an emergency department with cardiac symptoms suggestive of acute coronary syndrome$390.75

Numerous high-sensitivity cardiac troponin (hs-cTn) assays for acute myocardial infarction (MI) are available.1,2 These assays differ in their limits of detection, precision, and repeatability.3 The American College of Cardiology and American Heart Association guidelines endorse the 99th percentile upper reference limit for detecting myocardial injury to diagnose acute MI using hs-cTn.4 Evidence of myocardial injury with cardiac symptoms, new electrocardiogram changes, loss of viable myocardium per imaging, or evidence of coronary thrombus on angiography meets diagnostic criteria for acute MI.5 There is no standard cutoff value for hs-cTn. Abnormal values are based on a reference population for individual assays.

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This series is coordinated by Natasha Pyzocha, DO, contributing editor.

A collection of Diagnostic Tests published in AFP is available at https://www.aafp.org/afp/diagnostic.

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