More than 5% of patients had high-sensitivity troponin levels above the manufacturer's 99th percentile cutoff.
Diagnosis of acute myocardial infarction (MI) requires two of three findings: appropriate symptomatology, diagnostic electrocardiogram findings, and elevated biomarkers. Demand ischemia (i.e., type 2 MI) carries a worse prognosis than MI resulting from coronary occlusion (NEJM JW Cardiol Jul 2014 and Am J Med 2014; 127:295; NEJM JW Emerg Med Oct 2013 and Emerg Med J 2014; 31:882).
In a prospective, observational study, researchers at a U.K. hospital measured high-sensitivity troponin in patients who did not require troponin measurement for clinical care. Among 3706 emergency department patients, 6% had levels above the manufacturer's reported 99th percentile cutoff.
Reviewing Author
DisclosuresConsultant/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
DisclosuresConsultant/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