Can a Single Negative High-Sensitivity Troponin T Level Rule Out Myocardial Infarction?

Negative troponin testing combined with nonischemic electrocardiogram results and non–high-risk clinical presentation conferred a negative predictive value of 99.7%.

Prior studies have suggested that negative and nonincreasing high-sensitivity cardiac troponin (hsTn) levels measured at emergency department (ED) presentation and 1 hour later can rule out acute myocardial infarction (MI) in low-risk patients with nonischemic electrocardiogram (ECG) results (NEJM JW Emerg Med Feb 2016 and Ann Emerg Med 2016 Jan 12; [e-pub]; NEJM JW Emerg Med Jul 2016 and JAMA Cardiol 2016 Jun 1; [e-pub]). In the current study, investigators evaluated whether a single hsTnT level can rule out 30-day major adverse cardiac events (acute MI, unstable angina, cardiogenic shock, ventricular arrhythmia, atrioventricular block, cardiac arrest, or death of cardiac or unknown cause).

The prospective observational study included 1138 …

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Can a Single Negative High-Sensitivity Troponin T Level Rule Out Myocardial Infarction?

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Reviewing Author