Abstract

Strategies to rule out myocardial infarction (MI)2 in the emergency department include stress test echocardiography, electrocardiography, and assessment of cardiac biomarkers such as troponin I and T (1). The potential for new high-sensitivity cardiac troponin testing to simplify and expedite these rule-out protocols is of great interest. Is all the hype justified? Or are we placing unreasonable expectations on a single laboratory test? There are indeed data indicating that an undetectable or low high-sensitivity cardiac troponin concentration alone at presentation might be useful to rule out MI. Recent data, however, suggest that the addition of other tests may improve the performance and be even more cost-effective compared to high-sensitivity cardiac troponin alone (2, 3). As a …

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