High-sensitivity troponin tests for the early rule out of non-ST-segment elevation myocardial infarction (NSTEMI)
The improved accuracy of the high sensitivity test compared to the standard troponin test allows testing of troponin concentration and type (T or I) at 1-hour and/or 3-hours post ED presentation. This innovation adoption in both technology and pathway will greatly improve patient care and efficiency at ED, enabling patients to be sent home secure in the knowledge that a heart attack has not occurred while keeping beds free in ED.
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Our Programme has now seen all ED departments in South London operating with this HS Troponin pathway. Four suppliers are approved by NICE and a trust may choose one, typically choosing based on existing assay equipment held in pathology. ED and pathology must agree on an updated pathway with new IT codes embedded for clinicians to select the correct assay. The HIN has been working with Kingston ED and Kings on setting up this approach and the service is now embedded in practice.
National workshops given by leading cardiac specialists are available for ED clinicians to attend, to hear about advanced use of the assay and how it has benefited their trusts. The HIN holds templated business cases to support adoption and papers on the merits of the HS Troponin assay and improved use.
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We would love to hear about the use of HS Troponin where it is used within 0 and 3 hours. Please contact us for further information.