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Annales de Biologie Clinique

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Recommandations sur la prescription, le dosage et l’interprétation des troponines cardiaques Volume 63, issue 3, Mai - Juin 2005

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Authors
Laboratoire de biochimie, Hôpital Bel Air, CHR Metz-Thionville, Service de cardiologie et USIC, CHU Trousseau, Tours, Laboratoire de biochimie, Centre Hospitalier R. Dubos, Pontoise, Laboratoire de biochimie, Hôpital cardiologique, CHRU de Lille, Laboratoire Biolille, Lille, Centre cardiologique du Nord, Saint-Denis, Laboratoire de biochimie médicale, Hôpital Charles Nicolle, CHRU Rouen, Service de biochimie et hormonologie, Hôpital Tenon, Paris, Laboratoire central, Centre hospitalier de Calais, Service des urgences, CHU Jean Verdier, Bondy, Collège national de biochimie des hôpitaux, Centre hospitalier, Annonay, Société française de cardiologie, Paris, Société francophone de médecine d’urgence, Hôpital Broussais, Paris, GERBAP (Groupe d’évaluation et de recherche des biologistes de l’AP-HP ; Groupe « Marqueurs Cardiaques »)

Troponin (I or T) has become the gold-standard marker in acute coronary syndromes during the last few years, as confirmed by a national survey realized within french clinical chemists, cardiologists and emergency practitioners. The importance of this marker and the heterogeneousness of circulating forms of troponin after myocardial necrosis fully justify international studies about standardization of this assay, which is a central bulk to reach a global market coherence. Checking analytical problems, although necessary, must be absolutely associated with an informed clinical interpretation. The knowledge of the crucial thresholds of each assay, the kinetic curves and the specificity limits of troponin assays allow the best use of their potential in diagnosis and prognosis together with an optimal patient care in very different clinical settings, in addition to others clinical and technical arguments. The quality improvement through successive generations of assay kits must nowadays persuade the physicians never to ignore a significant and valid troponin increase, which mainly reveals a cardiac injury, whatever its origin.