Letter by Kavsak and MacRae Regarding Article, “Utility of Absolute and Relative Changes in Cardiac Troponin Concentrations in the Early Diagnosis of Acute Myocardial Infarction”

Abstract

To the Editor: Reichlin and colleagues1 report further findings from the Advantageous Predictors of Acute Coronary Syndrome Evaluation (APACE) trial, this time presenting data assessing absolute versus relative concentration changes in cardiac troponin (cTn) for the diagnosis of acute myocardial infarction (AMI). Their finding that an absolute difference in cTn is superior to relative change is important in reinforcing the value of using change criteria. However, questions persist about whether focusing solely on either the absolute change or on a relative change is appropriate or practical in the context of the diagnosis of AMI, or for subsequent prognosis for an adverse cardiac event. Counter to statements made by the authors, …