In the CME article „The Interdisciplinary Management of Acute Chest Pain,“ the rule-in and rule-out criteria are presented within a proposed 1-hour algorithm (1). Dissemination of such criteria for the hs-cTnI assay (Dimension Vista, Siemens Healthcare) is highly dangerous, as there is no such assay on the market—the only available assay is several-fold less sensitive. While these criteria have been recently included in the European Guidelines, they have only been used with an assay intended for research that has never reached market maturity.
These statements are therefore dangerous, as physicians who work in hospitals, and whose laboratories are equipped with the Dimension Vista analysis system, may wrongly assume that the troponin I assay can be applied to the criteria. Within the daily routine, it can happen that not enough attention is paid to the units of the laboratory values (given here as ng/L), which could lead to fatal misjudgements. I have published a letter concerning this in „Clinical Chemistry and Laboratory Medicine“ (2).
I would kindly request that you correct this, as presenting this incorrect figure could have serious consequences for patients
Footnotes
Conflict of interest statement
The author declares that no conflict of interest exists.
References
- 1.Bruno RR, Donner-Banzhoff N, Söllner W, Frieling T, Müller C, Christ M. The interdisciplinary management of acute chest pain. Dtsch Arztebl Int. 2015;112:768–780. doi: 10.3238/arztebl.2015.0768. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Zur B, Stoffel-Wagner B. Misleading high-sensitivity troponin algorithm for NSTEMI in the ESC guidelines. Clin Chem Lab Med. 2015;53 doi: 10.1515/cclm-2015-0881. [DOI] [PubMed] [Google Scholar]