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Acute Coronary Syndrom

Abstract

Recommended Article

Aggressive Measures to Decrease "Door to Balloon" Time and Incidence of Unnecessary Cardiac Catheterization: Potential Risks and Role of Quality Improvement High-Sensitivity Troponins and Outcomes After Myocardial Infarction Symptom onset-to-balloon time and mortality in the first seven years after STEMI treated with primary percutaneous coronary intervention Comparison of hospital variation in acute myocardial infarction care and outcome between Sweden and United Kingdom: population based cohort study using nationwide clinical registries Balloon-to-door time: emerging evidence for shortening hospital stay after primary PCI for STEMI Comparison of Outcomes of Patients With ST-Segment Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention Analyzed by Age Groups (<75, 75 to 85, and >85 Years); (Results from the Bremen STEMI Registry) The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE) Prospective Study of Percutaneous Coronary Intervention: Study Design Prognostic Significance of Complex Ventricular Arrhythmias Complicating ST-Segment Elevation Myocardial Infarction

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.