Early Rule Out of Myocardial Infarction With a Novel High-Sensitivity Cardiac Troponin T Assay

Can a novel high-sensitivity cardiac troponin T (hs-cTnT) assay with enhanced precision at very low concentrations improve the rule out of myocardial infarction with a single test?In this cohort study of 987 patients with possible myocardial infarction, if an early rule-out pathway using the novel sixth-generation hs-cTnT assay had been applied, almost one-half of patients would have been identified as low risk at presentation, compared with one-fifth of patients with guideline-recommended approaches using the current hs-cTnT assay.Results suggest that the sixth generation hs-cTnT assay could identify more patients as suitable for discharge after a single cardiac troponin measurement, compared with the fifth-generation assay; studies are required to evaluate whether implementation leads to a reduction in serial testing and length of stay in practice.

Corresponding Author: Alexander J. F. Thurston, MD, BHF Centre for Cardiovascular Science, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK (a.j.f.thurston@ed.ac.uk).

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