CAP Pro Course - Chemistry - Cardiac Biomarkers

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Author: Lynne Brodeur, MA, MLS(ASCP)CM
Reviewer: DeRhonda Crawford, MT(ASCP)

Continuing Education Credits

Objectives

  • List common tests used to assess acute cardiovascular injury in the acute care setting.
  • Compare and contrast troponin with high-sensitivity troponin (hsTn) assays.
  • Describe the current role of creatine kinase (CK) and creatine kinase MB isoform (CK-MB) testing in acute cardiovascular disease.
  • State the clinical significance of brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) measurement and discuss the differences between these two analytes.
  • Discuss the role of BNP and hsTn as cardiovascular risk markers rather than their established role as markers of myocardial infarction.
  • Explain how cardiac biomarkers are used in critical care diagnosis, risk stratification, and therapy monitoring.
  • Discuss the preanalytic, analytic, and postanalytic requirements for meeting quality standards for cardiac biomarker testing.

Course Outline

  • List common tests used to assess acute cardiovascular injury in the acute care setting.
      • Cardiac Biomarkers
      • Cardiac Biomarkers, continued
      • Congestive Heart Failure
      • Jennifer is a 57-year-old grandmother who is very active. Jennifer recently attended an aerobics class held at her local gym. Upon finishing the class...
      • In which disease is troponin not very useful for diagnosis?
      • Dr. Smith is a physician that has been in practice for over 50 years. He is mentoring a medical student. Upon making rounds in the cardiac ward, Dr. S...
  • Compare and contrast troponin with high-sensitivity troponin (hsTn) assays.
      • Troponin
      • Troponin, continued
      • Troponin Assay Performance
      • High-sensitivity Troponin (hsTn)
      • Why is a troponin test considered a critical test?
      • With the development of high-sensitivity troponin (hsTn) assays, there have been many implications for patient care. Which one of the following statem...
      • A patient arrives at his general practitioner's office suspecting he is having a heart attack. The physician's assistant at the office immediately beg...
  • Describe the current role of creatine kinase (CK) and creatine kinase MB isoform (CK-MB) testing in acute cardiovascular disease.
      • Creatine Kinase-MB
      • Creatine Kinase-MB, continued
      • You are teaching an MLS student from a local college how to run an instrument in your lab that uses spectrophotometry as a methodology. The student no...
      • Which one of the following statements is true?
  • State the clinical significance of brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) measurement and discuss the differences between these two analytes.
      • BNP and NT-proBNP
      • BNP versus NT-proBNP
      • Using Natriuretic Peptide Measurements
      • Your laboratory recently changed its brain natriuretic peptide (BNP) assay to the NT-proBNP assay. What should you tell the clinicians about this new ...
      • A patient enters the ER with a history of high blood pressure and diabetes. The physician orders a brain natriuretic peptide (BNP) and proceeds to loo...
      • You are the new supervisor of the chemistry laboratory at a local hospital with a large congestive heart failure (CHF) population. You are possibly lo...
  • Discuss the role of BNP and hsTn as cardiovascular risk markers rather than their established role as markers of myocardial infarction.
      • Risk Markers
      • hsTn as a Risk Marker
      • BNP and NT-proBNP as Risk Markers
      • Which of the following tests are not considered cardiovascular risk markers?
      • John has his blood drawn for total cholesterol, LDL, and HDL at his annual physical. His physician tells him he wants to get a cardiovascular risk sco...
      • Dr. Smith orders a BNP or NT-proBNP on all patients who have had a cardiovascular event. Which of the following is not a clinical utility of ordering ...
  • Explain how cardiac biomarkers are used in critical care diagnosis, risk stratification, and therapy monitoring.
      • Atherosclerosis and Progression to Acute Myocardial Infarction (AMI)
      • Differential Diagnosis of Acute Myocardial Infarction (AMI)
      • A 55-year-old male presents to the emergency department (ED) complaining of chest pain radiating through his arms and back, nausea, and shortness of b...
      • A 55-year-old male presents to the emergency department (ED) complaining of chest pain radiating through his arms and back, nausea, and shortness of b...
  • Discuss the preanalytic, analytic, and postanalytic requirements for meeting quality standards for cardiac biomarker testing.
      • Quality Standards of Cardiac Marker Testing
      • Critical Care Reporting of Results
      • The laboratory at XYZ hospital uses a cartridge-based system for troponin tests that come from the emergency department (ED). The cartridges can be st...
      • Why is it important to establish a short turnaround time for cardiac troponin testing?
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for MLS, MT, and MLT personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author: Lynne Brodeur, MA, MLS(ASCP)CM holds a master of arts degree in teaching. She is currently a full time lecturer at the University of Massachusetts Dartmouth and works per diem in Clinical Chemistry at St. Luke's Hospital in New Bedford, MA.
Reviewer Information: DeRhonda Crawford, MT(ASCP) is the chemistry supervisor at Gwinnett Medical Center in Lawrenceville, Georgia and the technical supervisor for the Gwinnett Medical Center in Duluth, Georgia. She holds a BS in Medical Technology from the Medical College of Georgia.

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