Supporting
Contemporary Cardiac Care
Focus on high-sensitivity troponin testing
By Dr David Deam
Published March 2026
Australian Clinical Labs will shortly withdraw CK-MB from its routine test repertoire. Contemporary practice now relies on cardiac troponin I or T as the recommended laboratory markers for myocardial infarction, reflecting their superior sensitivity and specificity.
Hospital admission and management decisions should not be delayed while awaiting laboratory results. Testing complements clinical assessment and ECG findings, particularly when ECG changes are non-specific or left bundle branch block is present.
High-sensitivity troponin assays typically become abnormal within 1–3 hours of symptom onset and may remain elevated for 7–10 days. Serial testing is recommended to demonstrate a rise or fall in concentration, with myocardial infarction defined by dynamic troponin change and at least one value above the 99th percentile in the appropriate clinical context.
GPs should continue to request high-sensitivity troponin for suspected acute coronary syndromes and contact the laboratory for advice in unusual cases or when CK-MB is being requested.
About the Author
Dr David Deam
MBBS MAACB FRCPA- endocrine function testing
- protein abnormalities
- laboratory automation
Dr Deam graduated with Honours in Medicine from Monash University in 1978 and obtained his FRCPA in 1985 following postgraduate training in Biochemistry at the Royal Melbourne Hospital. After several posts in Chemical Pathology at the Royal Melbourne Hospital and the Royal Women’s Hospital, he was appointed Head of Chemical Pathology at the Royal Melbourne in 1996. He joined Gribbles Pathology (now Australian Clinical Labs) in 1998.
Dr Deam has played an active role in teaching scientific, nursing and medical staff at both undergraduate and postgraduate levels and has been an examiner for the Australasian Association of Clinical Biochemists as well as the Royal College of Pathologists of Australasia.
Dr Deam’s research interests and publications include work on thyroid function testing, various aspects of diagnostic protein measurement and the rational use of biochemical tests. His special interests include testing of endocrine function; protein abnormalities; as well as laboratory automation and application of computing to pathology services.
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