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Review
. 2016 May;4(10):193.
doi: 10.21037/atm.2016.05.16.

Diagnostic algorithms for acute coronary syndrome-is one better than another?

Gianfranco Cervellin  1 , Camilla Mattiuzzi  1 , Chiara Bovo  1 , Giuseppe Lippi  1
Affiliations
Review

Diagnostic algorithms for acute coronary syndrome-is one better than another?

Gianfranco Cervellin et al. Ann Transl Med. 2016 May.

Abstract

The rather short history of diagnostic algorithms for investigating patients with a suspected acute coronary syndrome (ACS) has led to a constantly evolving and unquestionably chaotic scenario. Although the recent development and introduction of high-sensitivity immunoassays for the measurement of cardiac troponins has represented a paradigm shift for dispersing part of the overwhelming fog, many uncertainties remain, especially concerning the appropriate timing for serial testing and the interpretation of cardiac troponin variations over time. Therefore, the aim of this article is to review the available evidence about diagnostic algorithms for ACS which incorporate the measurement of cardiac troponins, and generate a final algorithm attempting to integrate and harmonize the many clinical and laboratory findings emerged from the recent scientific literature.

Keywords: Acute coronary syndrome (ACS); algorithm; diagnosis; myocardial infarction (MI); troponin.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The improved analytical sensitivity of cardiac troponin immunoassays and its relationship with the diagnosis of acute coronary syndrome. MI, myocardial infarction; UA, unstable angina.
Figure 2
Figure 2
Tentative algorithm for the rapid diagnosis of acute coronary syndrome. LOD, limit of detection; HS, high-sensitivity; MI, myocardial infarction.
See this image and copyright information in PMC

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