Alberta Precision Laboratories

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PLEASE NOTE: This Test Directory is in an interim state and due to changes pertaining to the DynaLIFE transition, performing site for routing has not been updated. Please refer to Laboratory Information System for appropriate routing.

Test Name/Synonym:

Troponin T, High Sensitivity (Synonym: HS-CTN, HSTNT)

Test Includes:

High sensitivity troponin T and Troponin Delta (see Additional Test Information)

Shipping and Handling Alert:

High sensitivity troponin T specimens sent for testing off-site from all collection locations except a Patient Service Center must be aliquotted before sending.

LABID (Connect Care):

LAB139

Specimen Type:

Blood

Primary Container:

Edmonton Zone: BARRICOR LIHEP
All other Zones: MINT LIHEP PST

Alternate Containers:

Edmonton Zone: MINT LIHEP PST
All other Zones: GOLD SST or LAVENDER EDTA

Minimum Collection Volume:

0.2 mL

Test Resources:

General Laboratory Requisition – 21302

Calgary Zone:

	Microcollection Minimum Whole Blood Volumes
	Calgary ED (Roche hs-cTnT) High Sensitivity Troponin-T Chest Pain Pathway

Edmonton Zone:

	Edmonton Zone Roche High Sensitivity Troponin T Chest Pain Pathway
	Edmonton Zone Roche High Sensitivity Troponin T Survival Guide for Physicians

Processing:

High Sensitivity troponin T specimens sent for testing off-site from all collection locations except a Patient Service Centre must be aliquoted before transporting.

Transportation:

Calgary Zone Patient Service Centres: Transport at ambient temperature.

South Zone and Central Zone Patient Service Centres: Transport at refrigerated temperature.

Method:

Roche high sensitivity troponin T.
WARNING: Different methods give potentially significantly different numerical values. Do not compare results from method to method.

Method and Interpretation of Results:

Result	Interpretation
Less than 5 ng/L	For patients with a non-ischemic ECG, a Troponin T, High Sensitivity of 4 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.
5-13 ng/L	Troponin T, High Sensitivity is below the upper reference limit (14 ng/L) and results are not consistent with myocardial infarction or injury. 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 change of 3 ng/L or less is highly sensitive for excluding acute myocardial infarction. A 2-hour change of 4-9 ng/L may indicate acute myocardial injury. Repeat clinical evaluation, ECG and troponin at 4-hours after the initial sample is recommended. A 2-hour change of 10ng/L 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.
14-52 ng/L	Troponin T, 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. 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 change of 3 ng/L or less suggests acute myocardial infarction is unlikely. A 2-hour change of 4-9 ng/L may indicate acute myocardial injury. Repeat clinical evaluation, ECG and troponin at 4-hours after the initial sample is recommended. A 2-hour change of 10 ng/L 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.
Greater than or equal to 53 ng/L	Clear elevation of Troponin T, 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.

For community patients:

Result	Comments
Less than 14 ng/L	Troponin T, High Sensitivity is below the upper reference limit (14 ng/L) and results are not consistent with myocardial infarction or injury, provided the specimen was collected more than 6 hours from the onset of symptoms. Patients with active symptoms, ischemic ECG changes and/or concerning clinical presentations should be considered for urgent evaluation irrespective of troponin results.
14-52 ng/L	Troponin T, 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. Patients with active symptoms. Ischemic ECG changes and/or concerning clinical presentations should be considered for urgent evaluation irrespective of troponin results.
Greater than or equal to 53 ng/L	Clear elevation of Troponin T, High Sensitivity consistent with myocardial injury or infarction. Interpretation is highly dependent on clinical presentation and patient history. Many patients have chronic elevations in troponin and measured concentrations near the patient’s baseline are reassuring. New troponin elevations are concerning and urgent assessment in an emergency department may be indicated in the appropriate clinical context.

Testing Schedule:

Daily

Reference Interval:

Less than 14 ng/L

Critical Value:

Greater than 52 ng/L

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

Calgary Zone: see critical values

Testing Area:

Biochemistry

Performing Site:

Calgary Zone	Alberta Children’s Hospital Diagnostic and Scientific Centre Foothills Medical Centre Peter Lougheed Centre Rockyview General Hospital South Health Campus
Central Zone	Red Deer Regional Hospital Centre
Edmonton Zone	Grey Nuns Hospital Misericordia Hospital Royal Alexandra Hospital Sturgeon Hospital University of Alberta Hospital
North Zone	Grande Prairie Regional Hospital
South Zone	Chinook Regional Hospital Medicine Hat Regional Hospital

Additional Test Information:

Hemolyzed specimens will be cancelled as hemolysis can lead to false negative test results. Repeat specimens within 6 hours that also have hemolysis will be reported with a comment regarding negative interference.

Troponin delta is a whole number in ng/L which is a calculation of the absolute difference between the current troponin result and the most recent troponin result within 4 hours.

Last Updated On:

Tuesday, December 3, 2024