ArticleCirculation2022
Rapid Exclusion of Acute Myocardial Injury and Infarction With a Single High-Sensitivity Cardiac Troponin T in the Emergency Department: A Multicenter United States Evaluation.
Article in Circulation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06059079 (Using Higher Cut-off Values to Diagnose Acute Myocardial Infarction in Patients With Elevated Hs-cTnT Concentrations), which is not on this map. Cited by 27 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Using Higher Cut-off Values to Diagnose Acute Myocardial Infarction in Patients With Elevated Hs-cTnT Concentrations
Who cites it
27 citing papers in PubMed, 45 citations in OpenAlex.
- Clinical performance of the next generation Elecsys Troponin T high-sensitivity Gen 6 assay in acute coronary syndrome (PERFORM-TSIX): study design.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Observational
- The Evolution of Accelerated Diagnostic Protocols for Suspected Myocardial Infarction.Journal of clinical medicine · 2026Review
- Introduction of High-Sensitivity Troponin Assay to Rural Tertiary Care Medical Center: Impact on Subsequent Cardiac Diagnostic Testing.Diagnostics (Basel, Switzerland) · 2026Article
- Early Rule Out of Myocardial Infarction With a Novel High-Sensitivity Cardiac Troponin T Assay.JAMA cardiology · 2026Article
- N-International journal of molecular sciences · 2026Article
- Long Troponin T to Separate Troponin Elevations Among Patients With Atrial Fibrillation Versus Myocardial Infarction.Journal of the American Heart Association · 2026Observational
- Analytical Error of Cardiac Troponin and Impact on the Performance of Accelerated Diagnostic Protocols in Patients with Acute Chest Pain.Clinical chemistry · 2025Observational
- Evaluation of sex-specific 0-h high-sensitivity cardiac troponin T thresholds for the risk stratification of non-ST-segment elevation myocardial infarction.Clinical chemistry and laboratory medicine · 2025Article
- Using higher cut-off values to diagnose acute myocardial infarction in patients with elevated hs-cTnT.Journal of biomedical research · 2025Article
- Deciphering Acute Coronary Syndromes Pathobiology Through Proteomics.Journal of cardiovascular development and disease · 2025Review
- A High-Sensitivity Troponin I Rapid Assay vs. a High-Sensitivity Troponin T Routine Assay in Acute Chest Pain Patients: A Prospective Monocentric Study.Journal of clinical medicine · 2025Article
- High-Sensitivity Cardiac Troponin Assays: From Implementation to Resource Utilization and Cost Effectiveness.The journal of applied laboratory medicine · 2025Review
- Expression of nucleotide-binding oligomerization domain-like receptor protein 1 in patients with acute myocardial infarction and its relationship with clinical prognosis.Frontiers in cardiovascular medicine · 2025Article
- Predictive value of dynamic changes in RvD1, sST2, and PIV levels for the prognosis of STEMI patients after PCI: a prospective study.Frontiers in cardiovascular medicine · 2025Article
- Enhanced Hypercoagulability Using Clot Waveform Analysis in Patients with Acute Myocardial Infarction and Acute Cerebral Infarction.Journal of clinical medicine · 2024Article
- Cardiac Troponin Levels in Patients with Chronic Kidney Disease: "Markers of High Risk or Just Noise''?Diagnostics (Basel, Switzerland) · 2024Review
- High-Sensitivity Troponin: Finding a Meaningful Delta.Journal of cardiovascular development and disease · 2024Review
- Cardiac biomarkers are associated with increased risks of adverse clinical outcomes after ischemic stroke.Journal of neurology · 2024Article
- Long-term prognosis of low high-sensitivity cardiac troponin T in the emergency department compared with the general population.Heart (British Cardiac Society) · 2024Article
- Barbed arrow-like structure membrane with ultra-high rectification coefficient enables ultra-fast, highly-sensitive lateral-flow assay of cTnI.Nature communications · 2024Article
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Authors and funding
21 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThere are good data to support using a single high-sensitivity cardiac troponin T (hs-cTnT) below the limit of detection of 5 ng/L to exclude acute myocardial infarction. Per the US Food and Drug Administration, hs-cTnT can only report to the limit of quantitation of 6 ng/L, a threshold for which there are limited data. Our goal was to determine whether a single hs-cTnT below the limit of quantitation of 6 ng/L is a safe strategy to identify patients at low risk for acute myocardial injury and infarction.
methodsThe efficacy (proportion identified as low risk based on baseline hs-cTnT<6 ng/L) of identifying low-risk patients was examined in a multicenter (n=22 sites) US cohort study of emergency department patients undergoing at least 1 hs-cTnT (CV Data Mart Biomarker cohort). We then determined the performance of a single hs-cTnT<6 ng/L (biomarker alone) to exclude acute myocardial injury (subsequent hs-cTnT >99th percentile in those with an initial hs-cTnT<6 ng/L). The clinically intended rule-out strategy combining a nonischemic ECG with a baseline hs-cTnT<6 ng/L was subsequently tested in an adjudicated cohort in which the diagnostic performance for ruling out acute myocardial infarction and safety (myocardial infarction or death at 30 days) were evaluated.
resultsA total of 85 610 patients were evaluated in the CV Data Mart Biomarker cohort, among which 24 646 (29%) had a baseline hs-cTnT<6 ng/L. Women were more likely than men to have hs-cTnT<6 ng/L (38% versus 20%,
conclusionsA single hs-cTnT below the limit of quantitation of 6 ng/L is a safe and rapid method to identify a substantial number of patients at very low risk for acute myocardial injury and infarction.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.