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With highly sensitive assays, we can now measure troponin levels much lower than those detectable by conventional assays. What is the prognostic importance of very small troponin elevations in outpatients? In an industry-supported study, investigators used a highly sensitive assay to measure the troponin T levels of 3679 patients with stable coronary artery disease and preserved LV systolic function (mean age, 64; 19% women) to see whether the results corresponded to participants' risks for subsequent adverse outcomes. In 407, (11.1%) the troponin T levels were above the 99th percentile for a sample of healthy controls (0.013 μg/L).
During a mean 5.2 years of follow-up, increased troponin levels were associated with an increased risk for car…