Startseite Detecting cardiac injury: the next generation of high-sensitivity cardiac troponins improving diagnostic outcomes
Artikel
Lizenziert
Nicht lizenziert Erfordert eine Authentifizierung

Detecting cardiac injury: the next generation of high-sensitivity cardiac troponins improving diagnostic outcomes

  • Giuseppe Lippi ORCID logo EMAIL logo , Carl J. Lavie und Fabian Sanchis-Gomar
Veröffentlicht/Copyright: 5. Mai 2025
Veröffentlichen auch Sie bei De Gruyter Brill
Manuskript einreichen Informationen für Autor*innen
Clinical Chemistry and Laboratory Medicine (CCLM)
Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine (CCLM) Band 63 Heft 10

Abstract

Cardiac injury, encompassing a spectrum of heart muscle damage, requires prompt and accurate diagnosis to improve patient outcomes. Early detection using cardiac biomarkers is vital for timely intervention and reducing mortality. This review highlights the role of high-sensitivity cardiac troponins (hs-cTns) in diagnosing cardiac injury. This article offers an overview of cardiac injury, including its causes, diagnostic challenges, and the evolution of biomarkers, up to the development and commercialization of “high-sensitivity” (hs-) cTns. The molecular structure of cardiac isoforms cTnI and cTnT, release kinetics, guidelines incorporation, diagnostic performance, and clinical application will be analyzed. It is concluded that the advent of hs-cTn assays has further expanded diagnostic capabilities by enabling the detection of low-level cTn elevations, which were previously undetectable using conventional methods. This enhanced sensitivity allows earlier identification of even minor cardiac injuries, facilitating prompt intervention and improving patient outcomes. However, this increased sensitivity also introduces interpretive challenges in understanding the nature of cardiac involvement, especially in distinguishing mild cTn elevations that may signify non-ischemic cardiac injury or be associated with other non-cardiac conditions.

Keywords: troponin; cardiac injury; cardia damage; myocardial infarction; diagnosis
Corresponding author: Prof. Giuseppe Lippi, Section of Clinical Biochemistry and School of Medicine, University Hospital of Verona, Piazzale L.A. Scuro, 10, Verona 37134, Italy, E-mail:

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: None declared.

  7. Data availability: All data are included in the article.

References

1. Thygesen, K, Alpert, JS, Jaffe, AS, Chaitman, BR, Bax, JJ, Morrow, DA, et al.. Fourth universal definition of myocardial infarction (2018). Circulation 2018;138:e618–51. https://doi.org/10.1016/j.gheart.2018.08.004.Suche in Google Scholar PubMed

2. Sanchis-Gomar, F, Lippi, G. Physical activity – an important preanalytical variable. Biochem Med (Zagreb) 2014;24:68–79. https://doi.org/10.11613/bm.2014.009.Suche in Google Scholar PubMed PubMed Central

3. Lippi, G, Lavie, CJ, Sanchis-Gomar, F. Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): evidence from a meta-analysis. Prog Cardiovasc Dis 2020;63:390–1. https://doi.org/10.1016/j.pcad.2020.03.001.Suche in Google Scholar PubMed PubMed Central

4. De Luca, G, Suryapranata, H, Ottervanger, JP, Antman, EM. Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: every minute of delay counts. Circulation 2004;109:1223–5. https://doi.org/10.1161/01.cir.0000121424.76486.20.Suche in Google Scholar PubMed

5. Lippi, G, Cervellin, G, Sanchis-Gomar, F. Prognostic value of troponins in patients with or without coronary heart disease: is it dependent on structure and biology? Heart Lung Circ 2020;29:324–30. https://doi.org/10.1016/j.hlc.2019.10.005.Suche in Google Scholar PubMed

6. Chabior, A, Tyminska, A, Pawlak, A, Giordani, A, Caforio, A, Grabowski, M, et al.. Advances in myocarditis management in the light of the latest research and recent guidelines of the European Society of Cardiology. Cardiol J 2024;31:342–51. https://doi.org/10.5603/cj.95175.Suche in Google Scholar PubMed PubMed Central

7. Matta, AG, Carrie, D. Epidemiology, pathophysiology, diagnosis, and principles of management of Takotsubo cardiomyopathy: a review. Med Sci Monit 2023;29:e939020. https://doi.org/10.12659/msm.939020.Suche in Google Scholar PubMed PubMed Central

8. Jan, MF, Tajik, AJ. Modern imaging techniques in cardiomyopathies. Circ Res 2017;121:874–91. https://doi.org/10.1161/circresaha.117.309600.Suche in Google Scholar

9. Giustino, G, Croft, LB, Stefanini, GG, Bragato, R, Silbiger, JJ, Vicenzi, M, et al.. Characterization of myocardial injury in patients with COVID-19. J Am Coll Cardiol 2020;76:2043–55. https://doi.org/10.1016/j.jacc.2020.08.069.Suche in Google Scholar PubMed PubMed Central

10. Lavie, CJ, Sanchis-Gomar, F, Lippi, G. Cardiac injury in COVID-19-echoing prognostication. J Am Coll Cardiol 2020;76:2056–9. https://doi.org/10.1016/j.jacc.2020.08.068.Suche in Google Scholar PubMed PubMed Central

11. McCord, J, Aurora, L, Lindahl, B, Giannitsis, E, Calle-Muller, C, Nowak, R, et al.. Symptoms predictive of acute myocardial infarction in the troponin era: analysis from the TRAPID-AMI study. Crit Pathw Cardiol 2019;18:10–15. https://doi.org/10.1097/hpc.0000000000000163.Suche in Google Scholar PubMed

12. Solomon, R, Nowak, R, Hudson, M, Moyer, M, Jacobsen, G, McCord, J. Is duration of symptoms predictive of acute myocardial infarction? Curr Probl Cardiol 2021;46:100555. https://doi.org/10.1016/j.cpcardiol.2020.100555.Suche in Google Scholar PubMed

13. Alexander, KP, Newby, LK, Cannon, CP, Armstrong, PW, Gibler, WB, Rich, MW, et al.. Acute coronary care in the elderly, part I: non-ST-segment-elevation acute coronary syndromes: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology. Circulation 2007;115:2549–69. https://doi.org/10.1161/circulationaha.107.182615.Suche in Google Scholar

14. Alexander, KP, Newby, LK, Armstrong, PW, Cannon, CP, Gibler, WB, Rich, MW, et al.. Acute coronary care in the elderly, part II: ST-segment-elevation myocardial infarction: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology. Circulation 2007;115:2570–89. https://doi.org/10.1161/circulationaha.107.182616.Suche in Google Scholar PubMed

15. Schulte, KJ, Mayrovitz, HN. Myocardial infarction signs and symptoms: females vs. males. Cureus 2023;15:e37522. https://doi.org/10.7759/cureus.37522.Suche in Google Scholar PubMed PubMed Central

16. Zareifopoulos, N. Is there such as a thing as non-ischaemic cardiac pain? Heart Asia 2016;8:54–5. https://doi.org/10.1136/heartasia-2016-010820.Suche in Google Scholar PubMed PubMed Central

17. Todiere, G, Barison, A, Baritussio, A, Cipriani, A, Guaricci, AI, Pica, S, et al.. Acute clinical presentation of nonischemic cardiomyopathies: early detection by cardiovascular magnetic resonance. J Cardiovasc Med (Hagerstown) 2023;24:e36–46. https://doi.org/10.2459/JCM.0000000000001412.Suche in Google Scholar PubMed

18. Mendis, S, Thygesen, K, Kuulasmaa, K, Giampaoli, S, Mahonen, M, Ngu Blackett, K, et al.. World Health Organization definition of myocardial infarction: 2008–09 revision. Int J Epidemiol 2011;40:139–46. https://doi.org/10.1093/ije/dyq165.Suche in Google Scholar PubMed

19. Lippi, G, Cervellin, G. Do we really need high-sensitivity troponin immunoassays in the emergency department? Maybe not. Clin Chem Lab Med 2014;52:205–12. https://doi.org/10.1515/cclm-2013-0524.Suche in Google Scholar PubMed

20. Haider, KH, Stimson, WH. Cardiac troponin-I: a biochemical marker for cardiac cell necrosis. Dis Markers 1993;11:205–15. https://doi.org/10.1155/1993/901687.Suche in Google Scholar PubMed

21. Cummins, P, Auckland, M. Detection of myocardial cell injury: evaluation of a novel cardiac-specific radioimmunoassay. Eur Heart J 1983;4(Suppl E):3.Suche in Google Scholar

22. Cummins, B, Auckland, ML, Cummins, P. Cardiac-specific troponin-I radioimmunoassay in the diagnosis of acute myocardial infarction. Am Heart J 1987;113:1333–44. https://doi.org/10.1016/0002-8703(87)90645-4.Suche in Google Scholar PubMed

23. https://www.ncbi.nlm.nih.gov/guide/proteins/ [Accessed 10 March 2025].Suche in Google Scholar

24. Bleier, J, Vorderwinkler, KP, Falkensammer, J, Mair, P, Dapunt, O, Puschendorf, B, et al.. Different intracellular compartmentations of cardiac troponins and myosin heavy chains: a causal connection to their different early release after myocardial damage. Clin Chem 1998;44:1912–8. https://doi.org/10.1093/clinchem/44.9.1912.Suche in Google Scholar

25. Lippi, G, Cervellin, G. Degradation of troponin I in serum or plasma: mechanisms, and analytical and clinical implications. Semin Thromb Hemost 2012;38:222–9. https://doi.org/10.1055/s-0032-1301419.Suche in Google Scholar PubMed

26. Eggers, KM, Hammarsten, O, Lindahl, B. Differences between high-sensitivity cardiac troponin T and I in stable populations: underlying causes and clinical implications. Clin Chem Lab Med 2023;61:380–7. https://doi.org/10.1515/cclm-2022-0778.Suche in Google Scholar PubMed

27. Laugaudin, G, Kuster, N, Petiton, A, Leclercq, F, Gervasoni, R, Macia, JC, et al.. Kinetics of high-sensitivity cardiac troponin T and I differ in patients with ST-segment elevation myocardial infarction treated by primary coronary intervention. Eur Heart J Acute Cardiovasc Care 2016;5:354–63. https://doi.org/10.1177/2048872615585518.Suche in Google Scholar PubMed

28. Denessen, EJS, Nass, SIJ, Bekers, O, Vroemen, WHM, Mingels, AMA. Circulating forms of cardiac troponin: a review with implications for clinical practice. J Lab Precis Med 2023;8:13. https://doi.org/10.21037/jlpm-22-66.Suche in Google Scholar

29. Lippi, G, Cervellin, G, Aloe, R, Montagnana, M, Salvagno, GL, Guidi, GC. Non-commutability of results of highly sensitive troponin I and T immunoassays. Biochem Med (Zagreb) 2012;22:127–9. https://doi.org/10.11613/bm.2012.015.Suche in Google Scholar PubMed PubMed Central

30. Clerico, A, Zaninotto, M, Aimo, A, Padoan, A, Passino, C, Fortunato, A, et al.. Advancements and challenges in high-sensitivity cardiac troponin assays: diagnostic, pathophysiological, and clinical perspectives. Clin Chem Lab Med 2025;63:1260–78. https://doi.org/10.1515/cclm-2024-1090.Suche in Google Scholar PubMed

31. Armbruster, DA, Pry, T. Limit of blank, limit of detection and limit of quantitation. Clin Biochem Rev 2008;29:S49–52.Suche in Google Scholar

32. Aakre, KM, Apple, FS, Mills, NL, Meex, SJR, Collinson, PO; The International Federation of Clinical Chemistry Committee on Clinical Applications of Cardiac Biomarkers (IFCC C-CB). Lower limits for reporting high-sensitivity cardiac troponin assays and impact of analytical performance on patient misclassification. Clin Chem 2024;70:497–505. https://doi.org/10.1093/clinchem/hvad185.Suche in Google Scholar PubMed

33. Apple, FS. A new season for cardiac troponin assays: it’s time to keep a scorecard. Clin Chem 2009;55:1303–6. https://doi.org/10.1373/clinchem.2009.128363.Suche in Google Scholar PubMed

34. Lyon, AW, Kavsak, PA, Lyon, OA, Worster, A, Lyon, ME. Simulation models of misclassification error for single thresholds of high-sensitivity cardiac troponin I due to assay bias and imprecision. Clin Chem 2017;63:585–92. https://doi.org/10.1373/clinchem.2016.265058.Suche in Google Scholar PubMed

35. Carlton, E, Body, R. Understanding cardiac troponin part 2: early rule out of acute coronary syndrome. Emerg Med J 2018;35:192–7. https://doi.org/10.1136/emermed-2017-207161.Suche in Google Scholar PubMed

36. Clerico, A, Zaninotto, M, Plebani, M. Rapid rule-in and rule-out protocols of acute myocardial infarction using hs-cTnI and hs-cTnT methods. Clin Chem Lab Med 2024;62:213–17. https://doi.org/10.1515/cclm-2023-1010.Suche in Google Scholar PubMed

37. Aakre, KM, Saenger, AK, Body, R, Collinson, P, Hammarsten, O, Jaffe, AS, et al.. Analytical considerations in deriving 99th percentile upper reference limits for high-sensitivity cardiac troponin assays: educational recommendations from the IFCC Committee on clinical application of cardiac bio-markers. Clin Chem 2022;68:1022–30. https://doi.org/10.1093/clinchem/hvac092.Suche in Google Scholar PubMed

38. Clerico, A, Zaninotto, M, Aimo, A, Cardinale, DM, Dittadi, R, Sandri, MT, et al.. Variability of cardiac troponin levels in normal subjects and in patients with cardiovascular diseases: analytical considerations and clinical relevance. Clin Chem Lab Med 2023;61:1209–29. https://doi.org/10.1515/cclm-2022-1285.Suche in Google Scholar PubMed

39. Diaz-Garzon, J, Fernandez-Calle, P, Sandberg, S, Ozcurumez, M, Bartlett, WA, Coskun, A, et al.. Biological variation of cardiac troponins in health and disease: a systematic review and meta-analysis. Clin Chem 2021;67:256–64. https://doi.org/10.1093/clinchem/hvaa261.Suche in Google Scholar PubMed

40. Koerbin, G, Potter, JM, Pinto do Nascimento, M, Cullen, L, Scanlan, SL, Woods, C, et al.. The intra-individual variation of cardiac troponin I: the effects of sex, age, climatic season, and time between samples. Clin Chem Lab Med 2022;60:1101–9. https://doi.org/10.1515/cclm-2022-0125.Suche in Google Scholar PubMed

41. Galli, C, Lippi, G. High-sensitivity cardiac troponin testing in routine practice: economic and organizational advantages. Ann Transl Med 2016;4:257. https://doi.org/10.21037/atm.2016.07.04.Suche in Google Scholar PubMed PubMed Central

42. Lippi, G. The mystifying nomenclature of cardiac troponin immunoassays. Scand J Clin Lab Invest 2014;74:273–7. https://doi.org/10.3109/00365513.2014.888590.Suche in Google Scholar PubMed

43. Sandoval, Y, Apple, FS, Mahler, SA, Body, R, Collinson, PO, Jaffe, AS, et al.. High-sensitivity cardiac troponin and the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guidelines for the evaluation and diagnosis of acute chest pain. Circulation 2022;146:569–81. https://doi.org/10.1161/circulationaha.122.059678.Suche in Google Scholar PubMed

44. Marjot, J, Kaier, TE, Martin, ED, Reji, SS, Copeland, O, Iqbal, M, et al.. Quantifying the release of biomarkers of myocardial necrosis from cardiac myocytes and intact myocardium. Clin Chem 2017;63:990–6. https://doi.org/10.1373/clinchem.2016.264648.Suche in Google Scholar PubMed PubMed Central

45. Alpert, JS, Thygesen, K, Antman, E, Bassand, JP, Lopez Sendon, JL, Rydén, L, et al.. Myocardial infarction redefined – a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol 2000;36:959–69. https://doi.org/10.1016/s0735-1097(00)00804-4.Suche in Google Scholar PubMed

46. Thygesen, K, Alpert, JS, White, HD; Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction, Jaffe, AS, Apple, FS, et al.. Universal definition of myocardial infarction. Circulation 2007;116:2634–53. https://doi.org/10.1161/circulationaha.107.187397.Suche in Google Scholar

47. Thygesen, K, Alpert, JS, Jaffe, AS, Simoons, ML, Chaitman, BR, White, HD, et al.. Third universal definition of myocardial infarction. Eur Heart J 2012;33:2551–67. https://doi.org/10.1093/eurheartj/ehs184.Suche in Google Scholar PubMed

48. Byrne, RA, Rossello, X, Coughlan, JJ, Barbato, E, Berry, C, Chieffo, A, et al.. 2023 ESC guidelines for the management of acute coronary syndromes. Eur Heart J 2023;44:3720–826. https://doi.org/10.1093/eurheartj/ehad191.Suche in Google Scholar PubMed

49. Rao, SV, O’Donoghue, ML, Ruel, M, Rab, T, Tamis-Holland, JE, Alexander, JH, et al.. 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for the management of patients with acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation 2025;151:e771–862. https://doi.org/10.1161/cir.0000000000001309.Suche in Google Scholar

50. Lyon, AR, Lopez-Fernandez, T, Couch, LS, Asteggiano, R, Aznar, MC, Bergler-Klein, J, et al.. 2022 ESC guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J 2022;43:4229–361. https://doi.org/10.1093/eurheartj/ehac244.Suche in Google Scholar PubMed

51. Lippi, G, Cervellin, G. Is one cardiac troponin better than the other? J Lab Precis Med 2019;4:19. https://doi.org/10.21037/jlpm.2019.04.06.Suche in Google Scholar

52. Chapman, AR, Mills, NL. High-sensitivity cardiac troponin and the early rule out of myocardial infarction: time for action. Heart 2020;106:955–7. https://doi.org/10.1136/heartjnl-2020-316811.Suche in Google Scholar PubMed PubMed Central

53. Krintus, M, Panteghini, M. Laboratory-related issues in the measurement of cardiac troponins with highly sensitive assays. Clin Chem Lab Med 2020;58:1773–83. https://doi.org/10.1515/cclm-2020-0017.Suche in Google Scholar PubMed

54. McCarthy, C, Li, S, Wang, TY, Raber, I, Sandoval, Y, Smilowitz, NR, et al.. Implementation of high-sensitivity cardiac troponin assays in the United States. J Am Coll Cardiol 2023;81:207–19. https://doi.org/10.1016/j.jacc.2022.10.017.Suche in Google Scholar PubMed PubMed Central

55. Neumann, FJ, Sousa-Uva, M, Ahlsson, A, Alfonso, F, Banning, AP, Benedetto, U, et al.. 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J 2019;40:87–165. https://doi.org/10.1093/eurheartj/ehy394.Suche in Google Scholar PubMed

56. Ljung, L, Reichard, C, Hagerman, P, Eggers, KM, Frick, M, Lindahl, B, et al.. Sensitivity of undetectable level of high-sensitivity troponin T at presentation in a large non-ST-segment elevation myocardial infarction cohort of early presenters. Int J Cardiol 2019;284:6–11. https://doi.org/10.1016/j.ijcard.2018.10.088.Suche in Google Scholar PubMed

57. Boeddinghaus, J, Nestelberger, T, Twerenbold, R, Neumann, JT, Lindahl, B, Giannitsis, E, et al.. Impact of age on the performance of the ESC 0/1h-algorithms for early diagnosis of myocardial infarction. Eur Heart J 2018;39:3780–94. https://doi.org/10.1093/eurheartj/ehy514.Suche in Google Scholar PubMed

58. Plebani, M, Laposata, M, Lundberg, GD. The brain-to-brain loop concept for laboratory testing 40 years after its introduction. Am J Clin Pathol 2011;136:829–33. https://doi.org/10.1309/ajcpr28hwhssdnon.Suche in Google Scholar

59. Hu, DN. [Study on ocular pharmacodynamics and pharmaceutics (author’s transl)]. Zhonghua Yan Ke Za Zhi 1979;15:230–2.Suche in Google Scholar

60. Collinson, P. Troponin measurement in routine clinical practice: the reality behind the guidelines. Eur Heart J Open 2022;2:oeac049. https://doi.org/10.1093/ehjopen/oeac049.Suche in Google Scholar PubMed PubMed Central

61. Ervasti, M, Penttila, K, Siltari, S, Delezuch, W, Punnonen, K. Diagnostic, clinical and laboratory turnaround times in troponin T testing. Clin Chem Lab Med 2008;46:1030–2. https://doi.org/10.1515/cclm.2008.185.Suche in Google Scholar PubMed

62. Al-Saleh, A, Alazzoni, A, Al Shalash, S, Ye, C, Mbuagbaw, L, Thabane, L, et al.. Performance of the high-sensitivity troponin assay in diagnosing acute myocardial infarction: systematic review and meta-analysis. CMAJ Open 2014;2:E199–207. https://doi.org/10.9778/cmajo.20130074.Suche in Google Scholar PubMed PubMed Central

63. Lipinski, MJ, Baker, NC, Escarcega, RO, Torguson, R, Chen, F, Aldous, SJ, et al.. Comparison of conventional and high-sensitivity troponin in patients with chest pain: a collaborative meta-analysis. Am Heart J 2015;169:6–16.e6. https://doi.org/10.1016/j.ahj.2014.10.007.Suche in Google Scholar PubMed

64. Westwood, M, Ramaekers, B, Grimm, S, Worthy, G, Fayter, D, Armstrong, N, et al.. High-sensitivity troponin assays for early rule-out of acute myocardial infarction in people with acute chest pain: a systematic review and economic evaluation. Health Technol Assess 2021;25:1–276. https://doi.org/10.3310/hta25330.Suche in Google Scholar PubMed PubMed Central

65. Lee, HK, McCarthy, CP, Jaffe, AS, Body, R, Alotaibi, A, Sandoval, Y, et al.. High-sensitivity cardiac troponin assays: from implementation to resource utilization and cost effectiveness. J Appl Lab Med 2025. https://doi.org/10.1093/jalm/jfae161.Suche in Google Scholar PubMed PubMed Central

66. Schreier, T, Kedes, L, Gahlmann, R. Cloning, structural analysis, and expression of the human slow twitch skeletal muscle/cardiac troponin C gene. J Biol Chem 1990;265:21247–53. https://doi.org/10.1016/s0021-9258(17)45353-1.Suche in Google Scholar

67. Vallins, WJ, Brand, NJ, Dabhade, N, Butler-Browne, G, Yacoub, MH, Barton, PJ. Molecular cloning of human cardiac troponin I using polymerase chain reaction. FEBS Lett 1990;270:57–61. https://doi.org/10.1016/0014-5793(90)81234-f.Suche in Google Scholar PubMed

68. Mesnard, L, Samson, F, Espinasse, I, Durand, J, Neveux, JY, Mercadier, JJ. Molecular cloning and developmental expression of human cardiac troponin T. FEBS Lett 1993;328:139–44. https://doi.org/10.1016/0014-5793(93)80981-y.Suche in Google Scholar PubMed

Received: 2025-04-03
Accepted: 2025-04-28
Published Online: 2025-05-05
Published in Print: 2025-09-25

© 2025 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Quality indicators: an evolving target for laboratory medicine
  4. Reviews
  5. Regulating the future of laboratory medicine: European regulatory landscape of AI-driven medical device software in laboratory medicine
  6. The spectrum of nuclear patterns with stained metaphase chromosome plate: morphology nuances, immunological associations, and clinical relevance
  7. Opinion Papers
  8. Comprehensive assessment of medical laboratory performance: a 4D model of quality, economics, velocity, and productivity indicators
  9. Detecting cardiac injury: the next generation of high-sensitivity cardiac troponins improving diagnostic outcomes
  10. Perspectives
  11. Can Theranos resurrect from its ashes?
  12. Guidelines and Recommendations
  13. Australasian guideline for the performance of sweat chloride testing 3rd edition: to support cystic fibrosis screening, diagnosis and monitoring
  14. General Clinical Chemistry and Laboratory Medicine
  15. Recommendations for the integration of standardized quality indicators for glucose point-of-care testing
  16. A cost-effective assessment for the combination of indirect immunofluorescence and solid-phase assay in ANA-screening
  17. Assessment of measurement uncertainty of immunoassays and LC-MS/MS methods for serum 25-hydroxyvitamin D
  18. A novel immunoprecipitation-based targeted liquid chromatography-tandem mass spectrometry analysis for accurate determination for copeptin in human serum
  19. Histamine metabolite to basal serum tryptase ratios in systemic mastocytosis and hereditary alpha tryptasemia using a validated LC-MS/MS approach
  20. Machine learning algorithms with body fluid parameters: an interpretable framework for malignant cell screening in cerebrospinal fluid
  21. Impact of analytical bias on machine learning models for sepsis prediction using laboratory data
  22. Immunochemical measurement of urinary free light chains and Bence Jones proteinuria
  23. Serum biomarkers as early indicators of outcomes in spontaneous subarachnoid hemorrhage
  24. High myoglobin plasma samples risk being reported as falsely low due to antigen excess – follow up after a 2-year period of using a mitigating procedure
  25. Candidate Reference Measurement Procedures and Materials
  26. Commutability evaluation of glycated albumin candidate EQA materials
  27. Reference Values and Biological Variations
  28. Health-related reference intervals for heavy metals in non-exposed young adults
  29. Hematology and Coagulation
  30. Practical handling of hemolytic, icteric and lipemic samples for coagulation testing in European laboratories. A collaborative survey from the European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM)
  31. Cancer Diagnostics
  32. Assessment of atypical cells in detecting bladder cancer in female patients
  33. Cardiovascular Diseases
  34. False-positive cardiac troponin I values due to macrotroponin in healthy athletes after COVID-19
  35. Diabetes
  36. A comparison of current methods to measure antibodies in type 1 diabetes
  37. Letters to the Editor
  38. The neglected issue of pyridoxal- 5′ phosphate
  39. Error in prostate-specific antigen levels after prostate cancer treatment with radical prostatectomy
  40. Arivale is dead ‒ Hooke is alive
  41. A single dose of 20-mg of ostarine is detectable in hair
  42. Growing importance of vocabularies in medical laboratories
  43. Congress Abstracts
  44. 62nd National Congress of the Hungarian Society of Laboratory Medicine Szeged, Hungary, August 28–30, 2025
https://doi.org/10.1515/cclm-2025-0418
Schlagwörter für diesen Artikel
troponin; cardiac injury; cardia damage; myocardial infarction; diagnosis

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Quality indicators: an evolving target for laboratory medicine
  4. Reviews
  5. Regulating the future of laboratory medicine: European regulatory landscape of AI-driven medical device software in laboratory medicine
  6. The spectrum of nuclear patterns with stained metaphase chromosome plate: morphology nuances, immunological associations, and clinical relevance
  7. Opinion Papers
  8. Comprehensive assessment of medical laboratory performance: a 4D model of quality, economics, velocity, and productivity indicators
  9. Detecting cardiac injury: the next generation of high-sensitivity cardiac troponins improving diagnostic outcomes
  10. Perspectives
  11. Can Theranos resurrect from its ashes?
  12. Guidelines and Recommendations
  13. Australasian guideline for the performance of sweat chloride testing 3rd edition: to support cystic fibrosis screening, diagnosis and monitoring
  14. General Clinical Chemistry and Laboratory Medicine
  15. Recommendations for the integration of standardized quality indicators for glucose point-of-care testing
  16. A cost-effective assessment for the combination of indirect immunofluorescence and solid-phase assay in ANA-screening
  17. Assessment of measurement uncertainty of immunoassays and LC-MS/MS methods for serum 25-hydroxyvitamin D
  18. A novel immunoprecipitation-based targeted liquid chromatography-tandem mass spectrometry analysis for accurate determination for copeptin in human serum
  19. Histamine metabolite to basal serum tryptase ratios in systemic mastocytosis and hereditary alpha tryptasemia using a validated LC-MS/MS approach
  20. Machine learning algorithms with body fluid parameters: an interpretable framework for malignant cell screening in cerebrospinal fluid
  21. Impact of analytical bias on machine learning models for sepsis prediction using laboratory data
  22. Immunochemical measurement of urinary free light chains and Bence Jones proteinuria
  23. Serum biomarkers as early indicators of outcomes in spontaneous subarachnoid hemorrhage
  24. High myoglobin plasma samples risk being reported as falsely low due to antigen excess – follow up after a 2-year period of using a mitigating procedure
  25. Candidate Reference Measurement Procedures and Materials
  26. Commutability evaluation of glycated albumin candidate EQA materials
  27. Reference Values and Biological Variations
  28. Health-related reference intervals for heavy metals in non-exposed young adults
  29. Hematology and Coagulation
  30. Practical handling of hemolytic, icteric and lipemic samples for coagulation testing in European laboratories. A collaborative survey from the European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM)
  31. Cancer Diagnostics
  32. Assessment of atypical cells in detecting bladder cancer in female patients
  33. Cardiovascular Diseases
  34. False-positive cardiac troponin I values due to macrotroponin in healthy athletes after COVID-19
  35. Diabetes
  36. A comparison of current methods to measure antibodies in type 1 diabetes
  37. Letters to the Editor
  38. The neglected issue of pyridoxal- 5′ phosphate
  39. Error in prostate-specific antigen levels after prostate cancer treatment with radical prostatectomy
  40. Arivale is dead ‒ Hooke is alive
  41. A single dose of 20-mg of ostarine is detectable in hair
  42. Growing importance of vocabularies in medical laboratories
  43. Congress Abstracts
  44. 62nd National Congress of the Hungarian Society of Laboratory Medicine Szeged, Hungary, August 28–30, 2025
Jetzt anmelden und 20% sparen
Institutioneller Zugang
Wie funktioniert Authentifizierung?
Haben Sie eine Idee, wie wir unsere Website verbessern können?
Bitte schreiben Sie uns.
© 2025 De Gruyter Brill
Heruntergeladen am 10.11.2025 von https://www.degruyterbrill.com/document/doi/10.1515/cclm-2025-0418/html?lang=de
Button zum nach oben scrollen