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Intravenous Statin Administration During Myocardial Infarction Compared With Oral Post-Infarct Administration A Randomized Trial of a 1-Hour Troponin T Protocol in Suspected Acute Coronary Syndromes: The Rapid Assessment of Possible ACS In the Emergency Department with High Sensitivity Troponin T (RAPID-TnT) Study Imaging Coronary Anatomy and Reducing Myocardial Infarction Dynamic Myocardial Ultrasound Localization Angiography Ticagrelor or Prasugrel in Patients with ST-Segment-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention Canadian SCAD Cohort Study: Shedding Light on SCAD From a United Front Myocardial Infarction Risk Stratification With a Single Measurement of High-Sensitivity Troponin I Oxygen therapy in ST-elevation myocardial infarction Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction: Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial Considerations for Single-Measurement Risk-Stratification Strategies for Myocardial Infarction Using Cardiac Troponin Assays
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Expert Opinion2018;3(2):112-113.

JOURNAL：JAMA Cardiol. Article Link

The Wait for High-Sensitivity Troponin Is Over—Proceed Cautiously

Korley FK Keywords: Acute Coronary Syndromes; Cardiology Emergency Medicine; Research Methods; Statistics; Ischemic Heart Disease

ABSTRACT

Since high-sensitivity troponin (hsTn) assays became available for clinical use in Europe in 2010, clinicians in the United States have been waiting eagerly for US Food and Drug Administration (FDA) approval. It is finally here. High-sensitivity troponin assays hold promise for earlier diagnosis of myocardial infarction (MI), a decrease in the time required to rule out MI, a reduction in sex bias in the diagnosis of MI, and an improvement in the diagnosis of cardiac injury in noncardiac conditions, among other effects. It may also result in a redefinition of the concept of unstable angina. In this issue of JAMA Cardiology, Peacock et al report findings from the first study of the diagnostic accuracy of the FDA-approved high-sensitivity troponin T (hsTnT) assay in patients in US emergency departments who were evaluated for suspected acute coronary syndrome (ACS). The authors deserve commendation for rigorously conducting a timely study that provides crucial data that will inform strategies for implementing hsTn in the United States. This rigorously implemented multicenter observational study generated important findings that may excite enthusiasts while making skeptics cautious.

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