Cardiac Troponin
for Earlier Diagnosis of Myocardial Infarctions
Time is Muscle – Earlier MI Diagnosis with Sensitive Troponin Assays
The detection of a rise and/or fall of cardiac troponin (cTn) plays a key role in the earlier diagnosis of myocardial infarction (MI). Cardiac troponins are markers of myocardial necrosis, and, because of their high cardiac-specificity, are the preferred biomarker for the diagnosis of MI.
Reliable Answers for Critical Needs
As a recognized worldwide leader in CVD testing, Siemens Healthineers is the only company offering multiple solutions for cardiac troponin I (cTnI) testing that meet the current guidelines for MI diagnosis§. Siemens’ high-sensitivity troponin I assays provide clinical sensitivity and precision for earlier detection of necrosis and MI than less-precise assays.
Troponin
Preferred Biomarker of Cardiac Injury
Troponin is a complex of three contractile regulatory proteins, troponin C, T and I, that control the calcium mediated interactions between actin and myosin in cardiac and skeletal muscles.
- Troponin I and T are specific to cardiac muscles, unlike troponin C which is associated with both cardiac and skeletal muscles.
- Troponin C is not used in the diagnosis of myocardial damage.
- Both Troponin I and Troponin T are released into circulation at the time of injury following the same release pattern in the system. However, cardiac Troponin I is slightly more differentiated from skeletal Troponin I than cardiac Troponin T is from skeletal Troponin T.
Cardiac troponins are released into circulation in response to myocardial necrosis. As such, cardiac troponins are the preferred biomarkers for the detection of cardiac injury, and have long assisted physicians in improving diagnostic strategies for the effective management of patients with chest pain.
- Relatively non-specific markers of myocardial damage, such as creatine kinase (CK), creatine kinase-MB (CK-MB), and myoglobin (MYO), were used in diagnostic laboratories prior to the commercial release of the troponin assays.
- Numerous clinical studies on troponin have indicated its superior cardiac specificity in comparison to CK, CK-MB, or MYO.
- Troponin levels remain elevated in the blood longer than CK-MB or MYO, providing an extended diagnostic window for MI.
High-Sensitivity Troponin I
High-Sensitivity Troponin I is the latest addition to Siemens Healthineers’ comprehensive cardiac menu to assist clinicians with the diagnosis and treatment of chest pain patients. Designed to aid in diagnosing acute myocardial infarctions (AMI) through the quantitative measurement of cardiac troponin I in serum or plasma, high-sensitivity troponin plays a critical role in the timely diagnosis of AMI, or heart attacks.
High-sensitivity Troponin I is now available on the Atellica® IM Analyzer, ADVIA Centaur®Immunoassay System, Dimension® EXL™† and Dimension Vista®† Integrated Systems.
- Offers improved patient care with a high-sensitivity cardiac troponin assay that meets current guideline recommendations
- Allows you to measure slight, yet critical, changes between serial troponin I values, giving you confidence in patient results at the low end of the assay range.
- Delivers reliable results from proven, trusted technology coupled with three new monoclonal antibodies.
Compared to traditional troponin assays, the Siemens Healthineers Atellica IM, ADVIA Centaur, Dimension EXL and Dimension Vista TNIH assays are able to detect lower levels of troponin and smaller changes to a patient’s troponin levels, which may be an early indication of AMI. This design affords clinicians greater confidence in patient results at the low end of the assay range by delivering precision that provides the ability to measure slight, yet critical, changes between serial troponin I values.
Precision at the low end is important to minimize analytic variation that could confuse a clinician’s assessment of a clinically significant change. With this data in hand, clinicians have the ability to more quickly diagnose and treat patients with suspected AMI, in some cases in as little as one to three hours.
Assay Specifications
Atellica IM High-Sensitivity Cardiac Troponin I Assay
| Sample Type | Serum, lithium heparin plasma |
| Sample Volume | 100 µL |
| Assay Range | 2.51 - 25,000.00 pg/mL |
| Time to First Result | 10 minutes |
| On-board Stability | 31 days |
| Calibration Interval | 47 days |
| LoB | 0.58 pg/mL |
| LoD | 1.27 pg/mL |
| LoQ | 2.51 pg/mL |
Dimension EXL High-Sensitivity Cardiac Troponin I Assay*
| Sample Type | Human serum, plasma (lithium heparin) |
| Sample Volume | 10 µL |
| Assay Range | 4.0 - 25,000.00 pg/mL (ng/L) |
| Time to First Result | 10 minutes |
| Throughput | Up to 200 tests/hour |
| On-board Stability | 7 days open well 30 days onboard unpunctured |
| LoB | 1.1 pg/mL (ng/L) |
| LoD | 2.7 pg/mL (ng/L) |
| LoQ (20% CV) | 4.0 pg/mL (ng/L) |
| LoQ (10% CV) | 12.0 pg/mL (ng/L) |
| 99th percentile (n = 2010) | Combined: 60.4 pg/mL (ng/L)† Male: 76.2 pg/mL (ng/L) Female: 51.4 pg/mL (ng/L) |
†99th percentile value determined using combined gender data and lithium heparin sample type.
Dimension Vista High-Sensitivity Cardiac Troponin I Assay*
| Sample Type | Human serum, plasma (lithium heparin) |
| Sample Volume | 10 µL |
| Assay Range | 3.0 - 25,000.00 pg/mL (ng/L) |
| Time to First Result | 10 minutes |
| Throughput | Up to 200 tests/hour |
| On-board Stability | 7 days open well 30 days onboard unpunctured |
| LoB | 1.0 pg/mL (ng/L) |
| LoD | 2.0 pg/mL (ng/L) |
| LoQ (20% CV) | 3.0 pg/mL (ng/L) |
| LoQ (10% CV) | 10.0 pg/mL (ng/L) |
| 99th percentile (n = 2010) | Combined: 58.9 pg/mL (ng/L)† Male: 78.5 pg/mL (ng/L) Female: 53.7 pg/mL (ng/L) |
†99th percentile value determined using combined gender data and lithium heparin sample type.
ADVIA Centaur High-Sensitivity Cardiac Troponin I Assay
| Sample Type | Human serum, plasma (lithium heparin) |
|---|---|
| Sample Volume | 100 µL |
| Assay Range | 2.50 – 25,000.00 pg/mL (ng/L) |
| Time to First Result | XP/XPT: 18 minutes |
| Throughput | Up to 240 tests/hour |
| On-board Stability | 28 days |
| Calibration Interval | 14 days |
| LoB | 0.90 pg/mL (ng/L) |
| LoD | 2.21 pg/mL (ng/L) |
| LoQ (20% CV) | 2.50 pg/mL (ng/L) |
| LoQ (10% CV) | 4.50 pg/mL (ng/L) |
| 99th Percentile | 47.34 ng/L (pg/mL) |
Cardiac Menu
| Atellica® Solution | ADVIA Centaur® Systems | Dimension® EXL™ Systems | IMMULITE® Systems | Stratus® CS Systems | ||
| BNP | √ | √ | √ | |||
| CKMB Mass | √ | √ | √ | √ | √ | √ |
| CKMB Isoenzyme | √ | √ | ||||
| D-Dimer | √ | √ | ||||
| High-Sensitivity CRP | √ | √ | √ | √ | ||
| High-Sensitivity Troponin I | √ | √1 | √† | √* | ||
| Myoglobin | √ | √ | √ | √ | √ | √ |
| NT-proBNP | √* | √* | √ | √ | √ | |
| Tnl-Ultra™ | √* | √ǂ | ||||
| Troponin I | √ǂ | √ǂ | √ | √ǂ |
* Not available for sale in the U.S.
ǂGuideline-acceptable
1. Available on the ADVIA Centaur XP and XPT Systems only
The products featured here may not be commercially available in all countries. Due to regulatory restrictions, their future availability cannot be guaranteed. Please contact your local Siemens Healthineers representative for further details.
Guideline-Acceptable Troponin I
ADVIA Centaur TnI-Ultra® Assay
The ADVIA Centaur® TnI-Ultra® assay provides clinicians with confidence to accurately rule out/in early acute myocardial infarction. The Acridinium Ester-based ADVIA Centaur TnI-Ultra assay is a highly precise assay that can measure very low concentrations of cardiac troponin I. This excellent precision exceeds the industry benchmark established by the Joint European Society of Cardiology/American College of Cardiology Committee of ≤10% CV at the 99th percentile of normal. The assay uses the patented high quantum yield AE (HQYAE) molecule which improved the analytical sensitivity by a factor of 5 over the previous ADVIA Centaur cTnI assay.
- Supports rapid triage of chest pain patients and improves acute care workflow between serial measurements with a time to first result in 18 minutes or less.
- Delivers confidence in the earlier detection of AMI with demonstrated clinically equivalent to high-sensitive cardiac troponin assays, meeting the guidelines criterion for ≤10%CV at the 99th percentile
- Provides reliability in results with almost a decade in clinical practice
Assay Specifications
| ADVIA Centaur XP/CP Assay Performance Summary | |
|---|---|
| Sample Type | Serum, Plasma (EDTA or Heparinized) |
| Sample Volume | 100 μL |
| Assay Range | 6 – 50,000 ng/L |
| Time to First Result | 18 minutes (XP) / 15 minutes (CP) |
| On-board Stability | 28 days |
| Calibration Interval | 28 days |
| Dilution | 2, 5, 10 |
| Analytical Sensitivity | 6 ng/L |
| CV 10% | 30 ng/L |
| 99th Percentile | 40 ng/L |
Cardiac Menu
| Atellica® Solution | ADVIA Centaur® Systems | Dimension® EXL™ Systems | IMMULITE® Systems | Stratus® CS Systems | ||
| BNP | √ | √ | √ | |||
| CKMB Mass | √ | √ | √ | √ | √ | √ |
| CKMB Isoenzyme | √ | √ | ||||
| D-Dimer | √ | √ | ||||
| High-Sensitivity CRP | √ | √ | √ | √ | ||
| High-Sensitivity Troponin I | √ | √1 | √* | √* | ||
| Myoglobin | √ | √ | √ | √ | √ | √ |
| NT-proBNP | √* | √* | √ | √ | √ | |
| Tnl-Ultra™ | √* | √ǂ | ||||
| Troponin I | √ǂ | √ǂ | √ | √ǂ |
* Not available for sale in the U.S.
ǂGuideline-acceptable
1. Available on the ADVIA Centaur XP and XPT Systems only
The products featured here may not be commercially available in all countries. Due to regulatory restrictions, their future availability cannot be guaranteed. Please contact your local Siemens Healthineers representative for further details.
LOCI Cardiac Troponin I Assay
The LOCI® Cardiac Troponin I assay on the Dimension® EXL™ and Dimension Vista® systems meets the standard of performance for accurate and rapid results required for timely AMI diagnosis. Employing unique oxygen channeling technology provides greater precision and low background signal with minimal noise improves sensitivity.
- Supports rapid triage of chest pain patients and improves acute care workflow between serial measurements (6h reduced to 3h protocols) with a time to first result in 12 minutes or less.
- Reduces the risk of interference with a low sample volume.
- Improves laboratory workflow with same tube troponin testing with other STAT chemistry assays.
- Delivers confidence in the earlier detection of AMI with demonstrated clinically equivalent to high-sensitive cardiac troponin assays, meeting the guidelines criterion for ≤10%CV at the 99th percentile
Assay Specifications
| Dimension EXL Systems | Dimension Vista Systems | |
|---|---|---|
| Sample Type | Serum, Plasma (Na or Li Heparin) | Serum, Plasma (Na or Li Heparin) |
| Sample Volume | 20 μL | 20 μL |
| Assay Range | 17 – 40,000 ng/L | 15 - 40,000 ng/L |
| Time to First Result | 11 minutes |