Alberta Precision Laboratories

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Test Name/Synonym:

Troponin I High Sensitivity, Beckman (Synonym: HS-CTN, HSTNI)

Collection Alert:

For specimens collected in LIME BARRICOR LIHEP, syringes cannot be used to fill tubes. A blood transfer device is required.
Grossly hemolyzed or clotted samples will be rejected by laboratory staff.

LABID (Connect Care):

LAB139

Specimen Type:

Blood

Primary Container:

LIME BARRICOR LIHEP

Alternate Containers:

Edmonton and North Zones:
MINT LIHEP PST

Minimum Collection Volume:

Tube should be filled to capacity. Minimum volume for 3 mL LIME BARRICOR LIHEP is 2 mL. 5.5 mL LIME BARRICOR LIHEP require a minimum 50% fill.

Test Resources:

2-Hour Chest Pain Pathway for High Sensitivity Troponin I hs-TnI - Beckman Access

Stability and Storage:

Room temperature: 4 hours
Refrigerated temperature: 24 hours
Freezer -20 degrees Celsius: 6 months

Processing:

For specimens collected in MINT LIHEP PST a double spin is required. Original sample tubes should not be re-centrifuged. Performing site staff to decant the plasma into an aliquot tube and re-spin.

Method:

Beckman Access2
WARNING: Different methods give potentially significantly different numerical values. Do not compare results from method to method.

Method and Interpretation of Results:

Hs-TnI Result (ng/L)	Comment	Flagging
Less than or equal to 3	For patients with a non-ischemic ECG, a Troponin I, High Sensitivity of 3 ng/L or less on presentation is highly sensitive for excluding acute myocardial infarction, provided the specimen was collected more than 3-hours from symptom onset. However, for patients with symptoms less than 3-hours duration or concerning clinical presentations, repeat troponin testing at 2-hours after the initial sample is recommended. Please note that patients with ischemic ECG changes and/or high-risk clinical presentations should be considered for further evaluation irrespective of troponin results.	Normal
4 – 17	Troponin I, High Sensitivity is below the upper reference limit (18 ng/L) and results are not consistent with myocardial infarction (MI) or injury, provided that more than 6 hours have passed from the onset of symptoms. Patients less than 6-hours from onset or who have concerning clinical presentations should undergo repeat troponin testing 2-hours after the initial sample. - Troponin I, High Sensitivity of 4 ng/L or less on presentation AND a 2-hour delta (change) of 4 ng/L or less is highly sensitive for excluding acute myocardial infarction (MI) - A 2-hour delta (change) of 5-19 ng/L may indicate acute myocardial injury and suggest an additional troponin measurement 4 hours after the initial sample, serial ECG testing and clinical re-evaluation. - A 2-hour delta (change) of 20 ng/L or more suggests an acute myocardial injury and may represent acute myocardial infarction in the appropriate clinical scenario. Please note that patients with ischemic ECG changes and /or high-risk clinical presentations should be considered for further evaluation irrespective of troponin results.	Normal
18 - 49	Troponin I, High Sensitivity has a non-specific/non-diagnostic elevation. Interpretation is highly dependent on clinical presentation and patient history. New elevations are concerning; however, many patients have chronic elevations in troponin and measured concentrations near the patient's baseline are reassuring. However, patients with acute symptoms (less than 6-hours) or concerning clinical presentations should undergo repeat troponin testing at 2-hours after the initial sample. - A 2-hour delta (change) of 4 ng/L or less is highly sensitive for excluding acute myocardial infarction. - A 2-hour delta (change) of 5-19 ng/L may indicate acute myocardial injury and suggest an additional troponin measurement 4 hours after the initial sample, serial ECG testing and clinical re-evaluation. - A 2-hour delta (change) of 20 ng/L or more suggests an acute myocardial injury and may represent acute myocardial infarction in the appropriate clinical scenario. Please note that patients with ischemic ECG changes and /or high-risk clinical presentations should be considered for further evaluation irrespective of troponin results.	High
Greater than or equal to 50	Clear elevation of Troponin I, High Sensitivity consistent with acute myocardial injury or infarction in the appropriate clinical context. Repeat troponin testing at 2-hours after the initial sample may be helpful to assess for ongoing myocardial injury.	Critical

Testing Schedule:

Daily

Reference Interval:

Less than 18 ng/L

Critical Value:

Greater than or equal to 50 ng/L

Emergency and inpatient critical Troponin I, High Sensitivity will not be communicated by telephone; only physicians of community patients with a critical value will be contacted

Testing Area:

Biochemistry

Performing Site:

Calgary Zone (CLS)	Airdrie Community Health Centre Banff Mineral Springs Hospital Canmore General Hospital Claresholm Health Centre Cochrane Community HC Didsbury District Health Services High River General Hospital Oilfields General Hospital Okotoks Health and Wellness Centre Sheldon M. Chumir Health Centre South Calgary Health Centre Strathmore District Health Services Vulcan Community Health Centre
Central Zone	Camrose – St. Mary’s Hospital Drayton Valley Hospital and Care Centre Drumheller HC Innisfail Health Centre Lacombe Hospital and Care Centre Olds Hospital and Care Centre Ponoka Hospital Rimbey Hospital and Care Centre Rocky Mountain House Health Centre Stettler Hospital and Care Centre Sundre Hospital and Care Centre Three Hills HC Vegreville – St. Joseph’s General Hospital Vermilion HC Wainright Health Centre Wetaskiwin Hospital and Care Centre
Edmonton Zone	Devon General Hospital East Edmonton Health Centre Fort Saskatchewan Community Hospital Leduc Community Hospital Northeast Community Health Centre Redwater Health Centre Strathcona Community Hospital Westview Health Centre
North Zone	Athabasca Healthcare Centre Barrhead Healthcare Centre Beaverlodge Municipal Hospital Bonnyville Healthcare Centre Fairview Health Complex High Prairie Health Complex Hinton Healthcare Centre Mayerthorpe Healthcare Centre Northwest Health Centre-High Level Peace River Community Healthcare Centre Slave Lake Healthcare Centre Valleyview Health Centre Westlock Healthcare Centre
South Zone	Brooks Health Centre Cardston Hospital Pincher Creek Hospital Raymond Hospital Taber Hospital

Last Updated On:

Tuesday, February 11, 2025