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. 2015 May;128(5):493–501.e3. doi: 10.1016/j.amjmed.2014.10.056

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© 2015 The Authors

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

PMC Copyright notice

Change in the investigation, management, and clinical outcomes of patients with type 1 myocardial infarction, type 2 myocardial infarction, and myocardial injury after implementation of a sensitive troponin assay. In patients with troponin concentrations of 50 to 199 ng/L and type 1 myocardial infarction, lowering the diagnostic threshold increased referrals for a specialist opinion, further investigation, and treatments for myocardial infarction (P < .01 for all). For patients with type 2 myocardial infarction and myocardial injury, similar patterns were seen, although the absolute magnitude was smaller. In patients with type 1 myocardial infarction, lowering the diagnostic threshold was associated with a significant reduction in recurrent myocardial infarction (absolute risk reduction, 12%; 95% CI, 3-23), whereas outcomes in patients with type 2 myocardial infarction and myocardial injury remained unchanged. DAPT = dual antiplatelet therapy; MI = myocardial infarction; PCI = percutaneous coronary intervention. *P < .05. ** P < .01. ***P < .001.