[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-566680-105":53,"doc-detail-566680-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","troponin-when-to-request-in-primary-care","Troponin - When to request in Primary Care","","This clinical guidance document, issued by the Scarborough, Hull and York Pathology Service (SHYPS), provides essential protocols for requesting troponin tests in a primary care setting. It defines the Universal Definition of Myocardial Infarction, identifies the 99th centile threshold for Troponin T at 14ng/L, and provides clear instructions on when to avoid troponin testing, emphasizing that suspected acute coronary syndrome (ACS) requires immediate emergency intervention. The guide outlines the clinical interpretation of various Troponin T levels and lists non-cardiac causes for elevated troponin results. It serves as a vital resource for GPs in making informed referral decisions, stressing that troponin measurement should only complement clinical judgment and ECG findings for patients with suspected ACS symptoms occurring more than 72 hours prior and who are currently pain-free. The document also details the laboratory's protocol for communicating significant results to primary care providers.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":51,"@type":70,"position":76},"https://docshare.wps.com/template/general/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/troponin-when-to-request-in-primary-care/566680/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/troponin-when-to-request-in-primary-care/566680.png","ImageObject",442,249,{"name":88,"@type":89},"dabgoudw","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-27","2026-10-13",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",8,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"When should a primary care provider avoid requesting a troponin test?","Question",{"text":109,"@type":110},"Do not request troponin in primary care if the patient has suspected acute coronary syndrome (ACS), which requires a 999 call, or if they have experienced symptoms suggestive of ACS within the last 72 hours, which requires urgent emergency department assessment.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What is the 99th centile threshold for Troponin T?",{"text":114,"@type":110},"The 99th centile for Troponin T is 14ng/L, meaning 99% of healthy individuals will have a value below this level.",{"name":116,"@type":107,"acceptedAnswer":117},"What non-cardiac conditions can cause elevated Troponin T levels?",{"text":118,"@type":110},"Elevated Troponin T in the absence of an MI can be caused by pulmonary embolism, renal failure, COPD, diabetes, acute neurological events, or drugs/toxins.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},566680,1792125240,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":50,"category_name":51,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":4},3985747860484,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Service: SHYPS/Biochemistry/Y&S  \nFilename: CB/UI/YS-16  \nVersion: 1  \nDate of Issue: March 2024  \nOwner: Alison Jones  \nTroponin testing in Primary Care   \nPlease refer to NICE Clinical Knowledge Summary (CKS) on Chest pain for more further information:  \n[https://cks.nice.org.uk/chest-pain](https://cks.nice.org.uk/chest-pain)  \nDO NOT request troponin in Primary Care / Community:  \n• If the patient has suspected acute coronary syndrome (ACS)– dial 999  \n• If the patient has had symptoms suggestive of ACS within the past 72h – urgent assessment in ED required  \nThe Universal Definition of MI requires: Rise or fall in cardiac troponin with  \n1 value above the 99th centile AND relevant ECG changes OR symptoms of ischaemia  \nThe 99th centile for Troponin T is 14ng/L. This means that 99% of healthy individuals will have a Troponin T \u003C14ng/L.  \nTroponin T results must be interpreted in light of the clinical presentation.  \nThe laboratory will phone primary care Troponin T results >14ng/L to either GP surgery or GP out of hours service.  \n\n| • TroponinT \u003C5ng/L\u003Cbr>• Troponin T 5-14ng/L\u003Cbr>• TroponinT 14-51ng/L\u003Cbr>• TroponinT >51ng/L | ACS is excluded if >3hr post chest pain ACS is unlikely if >3hr post chest pain\u003Cbr>Discuss with cardiology/ambulatory care Further assessment in ED usually required |\n| --- | --- |\n\nTroponin measurement may be useful to guide referral decisions, in combination with clinical judgement and ECG, in patients with suspected ACS >72h ago who are now pain free with no complications. Troponin is not helpful:  \n• If the chest pain is non-cardiac  \n• To diagnose angina  \nSome Non-Cardiac causes of elevated TroponinT in the absence of an MI:  \nPulmonary Embolism, Renal Failure, COPD, Diabetes, Acute neurological event, Drugs/Toxins  \nNon-acute / chronic elevations in TroponinT >14ng/L -seek Cardiology advice","cbCaih0boZv9X1Ln","https://ap.wps.com/l/cbCaih0boZv9X1Ln","pdf",249227,"English","# Troponin Testing Protocol\n## When to Request Troponin\n## Clinical Interpretation and Thresholds\n## Non-Cardiac Causes of Elevated Troponin\n## Laboratory Reporting Procedures","[{\"question\":\"When should a primary care provider avoid requesting a troponin test?\",\"answer\":\"Do not request troponin in primary care if the patient has suspected acute coronary syndrome (ACS), which requires a 999 call, or if they have experienced symptoms suggestive of ACS within the last 72 hours, which requires urgent emergency department assessment.\"},{\"question\":\"What is the 99th centile threshold for Troponin T?\",\"answer\":\"The 99th centile for Troponin T is 14ng/L, meaning 99% of healthy individuals will have a value below this level.\"},{\"question\":\"What non-cardiac conditions can cause elevated Troponin T levels?\",\"answer\":\"Elevated Troponin T in the absence of an MI can be caused by pulmonary embolism, renal failure, COPD, diabetes, acute neurological events, or drugs/toxins.\"}]","Troponin - When to request in Primary Care | PDF",1791863287]