NICE has assessed 3 assays which measure cardiac troponin levels in the blood, to help the NHS decide whether to use these products. The assays are called Elecsys Troponin T high sensitive, ARCHITECT STAT High Sensitive Troponin-I and AccuTnI+3.

Cardiac troponins are proteins which are released into the blood when heart muscle has been damaged, for example, during a heart attack. Currently, it can take 10–12 hours after a heart attack for troponin levels to rise, so 2 troponin tests are carried out (10–12 hours apart) to see if there is a change in troponin levels. For many people, this means they have to stay in hospital while the tests are done. The new troponin assays are able to pick up lower levels of troponin in the blood than older troponin assays, and they can be used to help doctors see a change in troponin levels sooner. If there is no change, then a patient may be able to go home.

The Elecsys Troponin T high sensitive and ARCHITECT STAT High Sensitive Troponin-I assays are recommended, alongside other investigations, to help doctors in emergency departments work out whether people with chest pain thought to be due to a heart problem are likely to be having a heart attack or not.

NICE has recommended research on the use of the AccuTnI+3 assay. This assay may be used in an emergency department if it is part of a research study. Details of your clinical assessment will be collected.

The evidence gathered during the review of this guidance will be passed to the Centre for Guidelines surveillance team and be considered during routine surveillance of NICE’s guideline on chest pain of recent onset: assessment and diagnosis.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)