With the gradual deepening of medical research, the application prospects of cardiac marker test are constantly expanding. Cardiac marker tests such as high-sensitivity troponin T, brain natriuretic peptide (BNP), and N-terminal pro-B-type natriuretic peptide play an increasingly important role in the diagnosis, risk stratification, and prognosis determination of cardiovascular diseases.
Currently, among the approximately 200 million non-cardiac surgery cases worldwide, about 50% of patients have a poor prognosis due to the risk of cardiac injury occurring when they are over 45 years old, even leading to death within 30 days after surgery. Clinical practice urgently needs optimal risk assessment indicators to strengthen the cardiovascular risk assessment and management of non-cardiac surgery patients during the perioperative period.
The results of a large-scale international prospective non-cardiac surgical patient vascular event cohort evaluation study showed that the elevated hs-cTnT level after non-cardiac surgery is significantly related to the risk of patient death within 30 days after surgery, and the absolute preoperative and postoperative changes of hs-cTnT≥5ng/L or hs-cTnT>40ng/L are independent predictors of 30-day death events.
Monitoring hs-cTnT levels during the perioperative period is of great significance for identifying the risk of MINS.
In recent years, the widespread use of cancer treatment has effectively improved the survival rate of cancer patients, but the problem of drug-induced cardiac toxicity cannot be ignored. Although the definitions of cardiac toxicity by the American Society of Echocardiography/European Association of Cardiovascular Imaging, the National Cancer Institute, ESC, and others differ, they all clearly point out that it is related to cancer treatment. Multiple research results have also confirmed that a variety of chemotherapy, targeted therapy drugs, and immune checkpoint inhibitors may induce cardiac toxicity, leading to cardiovascular-related complications. Currently, tools used to diagnose cardiac toxicity include electrocardiograms, echocardiography, nuclear imaging, magnetic resonance imaging, and cardiac marker test with high sensitivity, accuracy, and reproducibility as well as convenience.
With the increasingly widespread clinical application of cardiac marker test and its constantly expanding application prospects in different fields, the scientific and rational application of cardiac marker test is of great significance for comprehensively improving cardiovascular disease risk management.
In the clinical diagnosis and disease management of myocardial infarction patients, hs-cTnT test has been widely recognized for its high sensitivity and specificity. Dynamic evaluation of hs-cTnT levels combined with evidence of ischemia has become an important condition for the diagnosis of myocardial infarction. Several authoritative guidelines have made relevant recommendations on rapid triage processes based on hs-cTnT levels and have set high requirements for test time. In order to meet the clinical demand for hs-cTnT test that is both fast and accurate, the laboratory actively promotes the acceleration of sample turnover time, uses plasma instead of serum for the three tests of myocardial infarction, including hs-cTnT, shortens the sample centrifugation time, and significantly reduces the possibility of retest. After completing the pre-processing of plasma, the laboratory test can be completed in 9 minutes using a reagent kit. Eventually, the laboratory test results report can be issued within 20 minutes by a large-scale test analyzer.