Troponin assays in the assessment of the equine myocardium.
Abstract: In 2000, troponin assays were adopted as the test of choice for detection of myocardial injury in man. This decision was made after extensive testing and followed a 60 year search for a biomarker of myocardial damage with sufficient analytical sensitivity and specificity. This has led to proliferation of assays for use in human medicine, each requiring extensive testing and validation before it could be made available on the open market for human use. The search for ever-more analytically sensitive assays and for a standard reference material continues. The adoption of troponin testing in veterinary medicine followed shortly after its development for use in man, providing a much-needed means of detecting and monitoring myocardial damage in horses. However, application of these tests in veterinary medicine has exclusively involved use of assays designed for and clinically validated in human patients. There is no mandated requirement for test validation in veterinary medicine and, while many of these assays have been shown to be capable of detecting equine troponin, the wide diversity of available tests, lack of validation, absence of protocols for their use and lack of standardisation make their application problematic. The objective of this review article is to address this issue, offering guidance where data are available and encouraging caution where there are none. Ultimately, the overall goal of this review is to examine critically the use of troponin assays in the horse and to promote the accurate and appropriate interpretation of valid results.
© 2013 EVJ Ltd.
Publication Date: 2014-01-07 PubMed ID: 24215569DOI: 10.1111/evj.12209Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
- Review
Summary
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The research article discusses the use and appropriateness of troponin assays in detecting and monitoring heart muscle damage in horses. The article also emphasizes the need for validation, standardization, and protocol development for these tests in veterinary medicine, while offering guidance for accurate interpretation of valid results.
Objective and Purpose of the Study
- The primary motivation of the paper is to critically examine the use of troponin assays for detecting myocardial damage in horses.
- The study underscores the need for developmental protocols and standardization in addition to the validation of these tests within the field of veterinary medicine.
- It also aims to provide guidance on the proper interpretation of valid test results and stresses discretion in instances with limited or non-existent data.
The Use of Troponin Assays in Human Medicine
- In 2000, troponin assays became the first choice for detecting myocardial damage in humans.
- The decision to adopt these tests was made after extensive research and validation and represented a culmination of a 60-year quest for a precise biomarker of heart muscle damage.
- As a result, a profusion of these assays have been made for human use, each undergoing rigorous testing and validation processes before market release.
- Efforts are continuously made towards finding even more analytically sensitive assays and a standard reference material.
Adoption of Troponin Assays in Veterinary Medicine
- Veterinary medicine adopted the use of troponin tests shortly after they were developed for human use, filling a crucial need for a means to detect and monitor heart muscle damage in horses.
- However, application of these tests in veterinary medicine has mainly involved using methods designed for, and clinically validated in, human patients.
- Critical issues including a lack of mandatory requirement for test validation in veterinary medicine, diversity of available tests, absence of procedural protocols, and standardization issues cause the application of these tests to be a challenging process.
Review Findings and Recommendations
- The paper includes guidelines where data is available and advises caution where data is lacking, with the aim of promoting accurate and appropriate interpretation of valid test results.
- Ultimately, this review emphasizes the need for a critical examination of the use of troponin assays in horses, to ensure their appropriate usage and interpretation in veterinary medicine.
Cite This Article
APA
Rossi TM, Pyle WG, Maxie MG, Pearl DL, Physick-Sheard PW.
(2014).
Troponin assays in the assessment of the equine myocardium.
Equine Vet J, 46(3), 270-275.
https://doi.org/10.1111/evj.12209 Publication
Researcher Affiliations
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Ontario, Canada.
MeSH Terms
- Animals
- Heart Diseases / blood
- Heart Diseases / diagnosis
- Heart Diseases / veterinary
- Horse Diseases / diagnosis
- Horse Diseases / metabolism
- Horses
- Myocardium / metabolism
- Troponin / blood
- Troponin / metabolism
Citations
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