A Single High-Sensitivity Cardiac Troponin T Strategy for Ruling Out Myocardial Infarction

Abstract

Background. Ruling out acute myocardial infarction (AMI) in the emergency department (ED) is challenging. Studies have shown that a high-sensitivity cardiac troponin T (hs-cTnT) 3 h after symptom onset and in those with a nonischemic ECG and nonhigh risk history. Conclusions. A 0 h hs-cTnT cutoff of <9 ng/L safely rules out AMI/death within 30 days in a majority of chest pain patients and is a more effective strategy than the currently recommended <5 ng/L and <6 ng/L cutoffs. This trial is registered with NCT03421873.