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Currently available troponin assays are not sufficiently sensitive immediately after the onset of chest pain because they do not reliably detect very low levels of troponin; use of these assays might deprive patients without ST-segment elevation of the benefits of early intervention. In two prospective, multicenter, observational studies, researchers evaluated the diagnostic accuracy of newer, more-sensitive troponin assays for identifying myocardial infarction in patients who presented to emergency departments with chest pain. In both studies, cardiologists independently determined the final diagnoses using hospital records.
Reichlin and colleagues, in a partially industry-funded study, compared standard troponin T testing against four new …