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Higher neutrophil-to-lymphocyte ratio (NLR) increases the risk of suboptimal platelet inhibition and major cardiovascular ischemic events among ACS patients receiving dual antiplatelet therapy with ticagrelor Haptoglobin genotype: a determinant of cardiovascular complication risk in type 1 diabetes Relationship Between Hospital Surgical Aortic Valve Replacement Volume and Transcatheter Aortic Valve Replacement Outcomes Effects of Icosapent Ethyl on Total Ischemic Events: From REDUCE-IT Transcatheter Aortic Valve Replacement: Role of Multimodality Imaging in Common and Complex Clinical Scenarios Short Length of Stay After Elective Transfemoral Transcatheter Aortic Valve Replacement Is Not Associated With Increased Early or Late Readmission Risk Myocardial bridging of the left anterior descending coronary artery is associated with reduced myocardial perfusion reserve: a 13N-ammonia PET study Left Ventricular Hypertrophy and Clinical Outcomes Over 5 Years After TAVR: An Analysis of the PARTNER Trials and Registries Coronary Protection to Prevent Coronary Obstruction During TAVR: A Multicenter International Registry Association of Coronary Artery Calcium With Long-term, Cause-Specific Mortality Among Young Adults
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Expert Opinion2018;3(2):112-113.

JOURNAL：JAMA Cardiol. Article Link

The Wait for High-Sensitivity Troponin Is Over—Proceed Cautiously

Korley FK Keywords: Acute Coronary Syndromes; Cardiology Emergency Medicine; Research Methods; Statistics; Ischemic Heart Disease

ABSTRACT

Since high-sensitivity troponin (hsTn) assays became available for clinical use in Europe in 2010, clinicians in the United States have been waiting eagerly for US Food and Drug Administration (FDA) approval. It is finally here. High-sensitivity troponin assays hold promise for earlier diagnosis of myocardial infarction (MI), a decrease in the time required to rule out MI, a reduction in sex bias in the diagnosis of MI, and an improvement in the diagnosis of cardiac injury in noncardiac conditions, among other effects. It may also result in a redefinition of the concept of unstable angina. In this issue of JAMA Cardiology, Peacock et al report findings from the first study of the diagnostic accuracy of the FDA-approved high-sensitivity troponin T (hsTnT) assay in patients in US emergency departments who were evaluated for suspected acute coronary syndrome (ACS). The authors deserve commendation for rigorously conducting a timely study that provides crucial data that will inform strategies for implementing hsTn in the United States. This rigorously implemented multicenter observational study generated important findings that may excite enthusiasts while making skeptics cautious.

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