March 1, 2001Clinical Chemistry
Myocardial Infarction Redefined: Role of Cardiac Troponin Testing
Why the study?
Does cardiac troponin testing using the 99th percentile cutoff improve the diagnosis and risk stratification of myocardial infarction in patients with suspected ACS?
Population
Patients presenting with ischemic symptoms or suspected acute coronary syndrome (ACS)
Comparison
Cardiac troponin testing using the 99th… vs Previous diagnostic criteria
Design
Editorial
Authors
Discussion
Loading...
Member takes
Implication
This editorial strongly endorses the new ACC/AHA/ESC guidelines that redefine myocardial infarction based on elevated cardiac troponin above the 99th percentile, emphasizing its superior role in diagnosis and risk stratification.
Structured PICO
Does cardiac troponin testing using the 99th percentile cutoff improve the diagnosis and risk stratification of myocardial infarction in patients with suspected ACS?
P
Population
Patients presenting with ischemic symptoms or suspected acute coronary syndrome (ACS)
I
Intervention
Cardiac troponin testing (cTnI or cTnT) using the 99th percentile upper reference limit
C
Comparator
Previous diagnostic criteria (e.g., WHO criteria, CK-MB, or 97.5th percentile cutoffs)
O
Outcome
Detection of myocardial infarction and risk stratificationsurrogate
This editorial strongly endorses the new ACC/AHA/ESC guidelines that redefine myocardial infarction based on elevated cardiac troponin above the 99th percentile, emphasizing its superior role in diagnosis and risk stratification.
Limitations
- Majority of manufacturers currently cannot meet the 10% imprecision (CV) recommendations at the 99th percentile
- Variable and substantially lower concentrations for heparinized plasma vs serum in several assays
Cite This Study
Apple et al. (2001) studied this question.