Troponin vs Troponin-HS

[thegenius]

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We recently switched to Troponin-HS.

Troponin has units of ng / ml
Troponin-HS has units of ng / L

So does that mean that you can take troponin x 1000 and you'll get troponin-HS? Is it that simple? Or under no circumstances can you compare the two values.

Example:
Suppose you have a patient whose initial troponin is 1.0 ng / ml.
Second troponin is 1.5 ng / ml.
Third troponin-HS (not the original troponin) is 4,000 ng / L.

Is that the same as troponin 4 ng / ml?

 

[RustedFox]

Your mom has troponin.

 

[thegenius]

Suppose the fox in your avatar came to your ED complaining of chest pain.

Would you get an EKG?

 

[RustedFox]

Suppose the fox in your avatar came to your ED complaining of chest pain.

Would you get an EKG?

I'd be too freaked out over an anthropomorphic fox with the capability to speak the English language.

I suppose I'd consult psych... for myself.

 

[end stage fibro]

Medicine nerd here.

I believe high sensitivity trops are usually the t-isomer and old busted troponin is usually the i-isomer. I think they have different rates of rise too but not sure on that one

 

[Jabbed]

We recently switched to Troponin-HS.

Troponin has units of ng / ml
Troponin-HS has units of ng / L

So does that mean that you can take troponin x 1000 and you'll get troponin-HS? Is it that simple? Or under no circumstances can you compare the two values.

Example:
Suppose you have a patient whose initial troponin is 1.0 ng / ml.
Second troponin is 1.5 ng / ml.
Third troponin-HS (not the original troponin) is 4,000 ng / L.

Is that the same as troponin 4 ng / ml?

As @end stage fibro alluded to, it depends if it's measuring TnI or TnT-- this varies with manufacturer.

But yes, comparing hs-TnI to TnI or hs-TnT to TnT is a matter of moving the decimal point over 3 places.

 

[Apollyon]

Medicine nerd here.

I believe high sensitivity trops are usually the t-isomer and old busted troponin is usually the i-isomer. I think they have different rates of rise too but not sure on that one

Way not nerdy enough if you're not posting with absolutely certainty and being smug about it (irrespective of being correct or not)!

 

[wholeheartedly]

was your original assay troponin T or troponin I ?

 

[thegenius]

was your original assay troponin T or troponin I ?

I'll look in the EMR...I don't know.

 

[wholeheartedly]

in theory yes if the same troponin type, but in reality even if they are both troponin T they're probably not comparable just by converting units. you can probably get an idea by looking at the references ranges for each. if the reference cutoffs are not the same when converting units then you shouldn't compare between the two results because they are very different assays with different measuring systems to get the higher sensitivity there can be a slight shift in results.

for example there's info an a few different troponin assays, 99th percentile of reference range in blue:

• TnI 2 (2K41–30, 2000 test kit)/TnI 3 (2K41-38, 500 test kit) – Abbott diagnostics, Chicago, IL, USA. Architect system. Limit of detection (LOD) 0.010 μg/L, 99th percentile 0.028 μg/L, coefficient of variation (CV) <10% at 0.032 μg/L (reported to 3 decimal places). TnI 3 assay evolved from the TnI 2 version, utilising the same antibodies though with adjustments to the formulation in order to minimise background noise at low levels.
• 
  
• hsTnT (05092744190 Troponin T hs Elecsy – 200 test kit) – Roche Diagnostics, Indianapolis, IN, USA. Elecsys system. LOD 0.005 μg/L, 99th percentile 0.014 μg/L, CV <10% at 0.013 μg/L (reported to 3 decimal places).
• 
  
• TnT (04660307190 Troponin T STAT Gen – 100 test kit) – Roche Diagnostics, Indianapolis, IN, USA. Elecsys 2010 system. LOD 0.01 μg/L, 99th percentile <0.01 μg/L, CV <10% at 0.03 μg/L (reported to 2 decimal places).

Note, it's very possible your lab has correlation data between the two assays if you're really curious.

 

[end stage fibro]

Way not nerdy enough if you're not posting with absolutely certainty and being smug about it (irrespective of being correct or not)!

I'm a true hospitalist...I save the smugness for the ED admits 😏