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Cohort study
Serial changes in highly sensitive cardiac troponin improve the early diagnosis of acute myocardial infarction
  1. Tobias Reichlin,
  2. Christian Mueller
  1. Department of Internal Medicine, Division of Cardiology, University Hospital Basel, Basel, Switzerland
  1. Correspondence to Tobias Reichlin
    Department of Internal Medicine, Division of Cardiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland; treichlin{at}uhbs.ch

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Context

The recently introduced highly sensitive cardiac troponin (hsTn) assays have been shown to improve the diagnostic accuracy in the early diagnosis of acute myocardial infarction (AMI).1 ,2 Improvements in assay sensitivity however have significantly increased the number of positive hsTn tests in various conditions other than AMI. Utilisation of troponin changes to differentiate acute from chronic troponin elevations have been proposed to overcome this diagnostic challenge.3

Methods

In a prospective observational multi-centre study conducted in the chest pain units of three German centres between 2007 and 2008, a total of 1818 consecutive patients presenting …

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