Background: Troponin measurements are now central to the diagnosis of
acute coronary syndromes and for the stratification of the severity of cardiac
disease. Some laboratories have quickly adopted the new testing strategies, which
include troponin measurement for the diagnosis of acute myocardial infarction, while
others are still developing appropriate protocols for cardiac testing that they can
support financially. However, it is not known how widespread is the adoption of these
new strategies across the UK.
Methods: The National Audit Committee of the Association of Clinical
Biochemists commissioned two surveys in 1999 and 2001 to assess the status of cardiac
markers currently being offered by laboratories in the UK and how this service might
develop in the future.
Results: The results show that many laboratories are continuously
adapting and improving their cardiac marker testing in line with current
recommendations for acute myocardial infarction. Although most laboratories are
confident in the use of troponin measurement in the diagnosis of myocardial
infarction, they are less confident in the use of biochemical markers in assessing
prognostic outcome in the other cardiac conditions.
Conclusions: Finance, staffing and equipment constraints may offer
significant impediments to troponin testing with a 1-h turnaround time.
