{"id":7041,"date":"2011-03-22T16:08:35","date_gmt":"2011-03-22T20:08:35","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=7041"},"modified":"2011-07-19T17:44:30","modified_gmt":"2011-07-19T21:44:30","slug":"study-explores-lowering-the-troponin-diagnostic-threshold","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/03\/22\/study-explores-lowering-the-troponin-diagnostic-threshold\/","title":{"rendered":"Study Explores Lowering the Troponin Diagnostic Threshold"},"content":{"rendered":"<p>Lowering the troponin diagnostic threshold can significantly improve  outcomes after MI, claim Scottish investigators in <a href=\"http:\/\/jama.ama-assn.org\/content\/305\/12\/1210.short\">a report published in  <em>JAMA<\/em><\/a>. More than 2,000 patients with suspected ACS were  studied. Sixty-four percent of patients had troponin concentrations below 0.05 ng\/mL,  8% had concentrations from 0.05 to 0.19 ng\/mL, and 28% had  concentrations 0.20 ng\/mL or higher. By lowering the diagnostic  threshold from 0.20 ng\/mL to 0.05 ng\/mL, the risk of death and recurrent  MI was reduced from 39% to 21% in the group with troponin concentrations  from 0.05 to 0.19 ng\/mL during the validation phase of the study.<\/p>\n<p>The  authors write that \u201cthe appropriateness of continuing to lower the  threshold of plasma  troponin assay concentration to define increasing  numbers of patients  with MI may be questioned. This concern relates to  the potential to  reduce specificity and increase false-positive  diagnoses of MI. Our  study supports the contention that this is not the  case, rather the  concern relates to the potential for  misclassification of high-risk  patients through the use of outdated  diagnostic thresholds.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Lowering the troponin diagnostic threshold can significantly improve outcomes after MI, claim Scottish investigators in a report published in JAMA. More than 2,000 patients with suspected ACS were studied. Sixty-four percent of patients had troponin concentrations below 0.05 ng\/mL, 8% had concentrations from 0.05 to 0.19 ng\/mL, and 28% had concentrations 0.20 ng\/mL or higher. [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[245,688],"class_list":["post-7041","post","type-post","status-publish","format-standard","hentry","category-general","tag-mi","tag-troponins"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/7041","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=7041"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/7041\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=7041"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=7041"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=7041"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}