Research Original Investigation Efficacy of High-Sensitivity Troponin T in Identifying Very-Low-Risk Patients With Possible Acute Coronary Syndrome Invited Commentary The Wait for High-Sensitivity Troponin Is Over— Proceed Cautiously Frederick K. Korley, MD, PhD Since high-sensitivity troponin (hsTn) assays became avail- Furthermore, in the hsTnT era, there might be the temp- able for clinical use in Europe in 2010, clinicians in the United tation to base clinical decisions on initial hsTnT results. While States have been waiting eagerly for US Food and Drug Ad- this strategy may be safe for most patients, it may not be safe ministration (FDA) approval. It is finally here. High- for all patients. In the study cohort, the sensitivity of the ini- tial sample (at the 99th percentile upper reference level) was sensitivity troponin assays hold promise for earlier diag- 86% (95% CI, 79.7%-90.9%), and the negative predictive value Related article page 104 nosis of myocardial infarc- (NPV) was 98.2% (95% CI, 97.3%–98.9%). However, using the tion (MI), a decrease in the lower limit of quantitation of the assay (6 ng/L) as the decision- time required to rule out MI, a reduction in sex bias in the di- making cutoff, the NPV of the initial
JAMA Cardiology – American Medical Association
Published: Feb 13, 2018
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