Despite improved clinical care, heightened public awareness, and widespread health innovations, myocardial infarction (MI) is still responsible for nearly 12 million deaths worldwide each year, causing half of all deaths in several developed countries and representing one of the main causes of death in many developing countries. Nearly 2400 Americans die of MI each day, an average of 1 death every 37 s. It is estimated that in 2009, 785,000 Americans will have a new coronary attack, and about 470,000 will have a recurrent attack ( 1 American Heart AssociationHeart disease and stroke statistics—2009 update. http://www.americanheart.org/presenter.jhtml?identifier=3037327 Google Scholar ). Therefore, further efforts should be placed on early, accurate diagnosis and appropriate triage to prevent mortality and related morbidity ( 1 American Heart AssociationHeart disease and stroke statistics—2009 update. http://www.americanheart.org/presenter.jhtml?identifier=3037327 Google Scholar ). According to the new universal definition of MI, troponin testing is of paramount importance (if not the mainstay) in the diagnosis, because MI is diagnosed in the presence of clinical evidence of ischemia when blood levels of this most sensitive and specific biomarker are increased above the 99th percentile of a normal reference population ( 2 Thygesen K. Alpert J.S. White H.D. Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial InfarctionUniversal definition of myocardial infarction. Circulation. 2007; 116: 2634-2653 Crossref PubMed Scopus (2122) Google Scholar ). With the advent of the high-sensitive (hs) cardiac troponin T (cTnT) and I (cTnI) assays, however, a paradigm shift has occurred in the detection of myocardial stress, injury, ischemia, and infarction, as well as in the clinical management of patients with slightly increased troponin concentrations in blood. At variance with the traditional cardiac troponin cTnT assay (Roche Diagnostics; Basel, Switzerland), whose traditional cutoff is 0.03 μg/L, the 10%-Coefficient of Variation (CV) cutoff concentration of the new hs-cTnT immunoassay from Roche Diagnostics is as low as 0.009 μg/L, which is even lower than the 99th percentile value of the reference population (0.016 μg/L, diagnostic cutoff) ( 3 Mingels A. Jacobs L. Michielsen E. Swaanenburg J. Wodzig W. van Dieijen-Visser M. Reference population and marathon runner sera assessed by highly sensitive cardiac troponin T and commercial cardiac troponin T and I assays. Clin Chem. 2009; 55: 101-108 Crossref Scopus (246) Google Scholar ). Likewise, cTnT, the 10%-CV concentration of a new hs-cardiac Troponin I (cTnI) assay (Hs-cTnI assay, Beckman Coulter; Fullerton, CA, USA), has been reported to be as low as 8.66 ng/L, with 99th percentile estimates in lithium, heparin, serum, and ethylenediaminetetraacetic acid plasma of 9.20, 8.00, and 8.60 ng/L, respectively (the 99th percentile limit of the traditional Beckman Coulter AccuTnI assay is 0.04 μg/L) ( 4 Kavsak P.A. MacRae A.R. Yerna M.J. Jaffe A.S. Analytic and clinical utility of a next-generation, highly sensitive cardiac troponin I assay for early detection of myocardial injury. Clin Chem. 2009; 55: 573-577 Crossref PubMed Scopus (141) Google Scholar ).