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Implementation of an early rule-out pathway for myocardial infarction using a high-sensitivity cardiac troponin T assay
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  • Published on:
    The index of clinical suspicion is equally important
    • Rajeev Gupta, Consultant Cardiologist Mediclinic Al-Jowhara Hospital, Al Ain, United Arab Emirates (UAE).
    • Other Contributors:
      • Neelesh Gupta, Fellow cardiology

    Dear Sir,
    The article is interesting. We in the UAE are using high-sensitivity Troponin I for the last 8 years in all patients suspected of the acute coronary syndrome and all cardiovascular emergencies (for risk stratification) presenting in the emergency units. We observed many patients who presented after 3-hour of symptoms-onset with negative first high-sensitivity Troponin I (<5ng/L) showed positive second or a third repeat test, when we had high-index of suspicion clinically, largely because of chronic comorbidities like diabetes mellitus and expatriates from Bangaldesh. Therefore the message must be evaluated in light of overall picture and value of Troponin should be used only as one of the important markers.

    Conflict of Interest:
    None declared.