Why the study?
What is the specificity of elevated Troponin I levels for myocardial injury in clinical practice?
What is the specificity of elevated Troponin I levels for myocardial injury in clinical practice?
This retrospective review investigates the real-world specificity of cardiac troponin I for myocardial injury, questioning the claim of 100% specificity.
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Questions troponin I specificity in routine care; leaves open whether thresholds require prospective revalidation.
To the Editor. —The cardiac isoform of troponin I (TnI) has been touted as 100% specific for myocardial injury.1-3While serving on the consult service of a large teaching hospital, we occasionally have evaluated patients with chest pain and elevations of TnI levels in whom we were unable to find any evidence of myocardial injury. We reviewed consecutive patients evaluated at our hospital between January and June 1996 who had elevated serum TnI levels to determine the specificity of this assay for myocardial injury in clinical practice. Troponin I levels were obtained as part of routine clinical practice when myocardial injury was suspected, and 343 patients had 1 or more TnI values of 1.0 ng/mL or greater. Cardiac TnI was measured on the Stratus II analyzer (Baxter Dade, Miami, Fla) with a commercial immunoassay procedure that uses 2 monoclonal antibodies directed against different epitopes on TnI.4 Of the
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Scott Wright (1997) studied this question.
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