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

Abstract

We thank Kavsak and MacRae for taking interest in our recent clinical research assessing absolute versus relative concentration changes in cardiac troponin for the diagnosis of acute myocardial infarction (AMI).1 We found that the diagnostic accuracy for AMI of absolute cardiac troponin changes is very high and markedly superior in comparison with corresponding relative changes. The method used for comparison was a simple receiver operating characteristic curve, which is an established test to measure the diagnostic accuracy of a test. Kavsak and MacRae questioned “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,” and therefore further suggested combining …