A number of assay-related issues can affect the performance of cardiac
troponin (
cTn) measurement in everyday practice. In this respect, it is vital that all information on
cTn assays is known and that the performance characteristics of assays are objectively assessed and adequately described. The advent of the latest generation of more sensitive
cTn assays has heralded a new wave of information about low concentrations of
cTn in blood. These recent generation assays have improved analytical sensitivity and corresponding performance at low
cTn concentrations when compared to their predecessors, providing a convincing goal for laboratory medicine in helping clinicians in the diagnosis of acute
myocardial infarction. Crucial to the clinical utility of highly sensitive
cTn assays is the laboratorians' role in closely scrutinizing proposed assays and defining their value in relation to available evidence. Analytical, as well as pre-analytical and post-analytical, aspects must be documented. In this review, we describe what laboratory professionals should know about their
cTn assay performance characteristics and the pre-analytical prerequisites for robustness to ensure optimal post-analytical reporting.