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Long-term survival and causes of death in patients with ST-elevation acute coronary syndrome without obstructive coronary artery disease Coronary CT Angiography and 5-Year Risk of Myocardial Infarction Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association Circulating MicroRNAs and Monocyte-Platelet Aggregate Formation in Acute Coronary Syndrome Culprit versus multivessel coronary intervention in ST-segment elevation myocardial infarction: a meta-analysis of randomized trials Prevalence of Coronary Vasospasm Using Coronary Reactivity Testing in Patients With Spontaneous Coronary Artery Dissection Association Between Collateral Circulation and Myocardial Viability Evaluated by Cardiac Magnetic Resonance Imaging in Patients With Coronary Artery Chronic Total Occlusion Impact of the US Food and Drug Administration–Approved Sex-Specific Cutoff Values for High-Sensitivity Cardiac Troponin T to Diagnose Myocardial Infarction Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3—PRIMULTI): an open-label, randomised controlled trial An open-Label, 2 × 2 factorial, randomized controlled trial to evaluate the safety of apixaban vs. vitamin K antagonist and aspirin vs. placebo in patients with atrial fibrillation and acute coronary syndrome and/or percutaneous coronary intervention: Rationale and design of the AUGUSTUS trial
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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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