Table 8.

Patients With 90‐Day MI or Death Missed by hsTnT < 6 ng/L at ED Arrival^a

Initial hsTnT (ng/L)	Outcome	Clinical Features
4	AMI < 90 d	ED visit for possible angina Sep 2, 2013; discharged after investigations with outpatient follow‐up. Return ED visit with NSTEMI and PCI on Oct 4, 2013.
4	AMI < 30 d	Chest pain presentation, serial hsTnT concentrations 4 and 5 ng/L. Discharged with outpatient follow‐up. Re‐presented 29 days after index ED visit with chest pain, hsTnT concentration 26 and 28 ng/L, maximum hsTnT 82 ng/L. Underwent PCI on Day 30 post‐ED index visit.
4	Acute MI < 7 d	Chest pain. Initial hsTnT level 4 ng/L. Serial TnT level 86 ng/L 4 h after ED arrival. Admitted and underwent PCI.
<3	Noncardiac death < 7 d	Chest pain, dyspnea, and hypoxemia. Initial hsTnT < 3 ng/L. AMI ruled out. Died same day of pneumosepsis.
4	Noncardiac death < 7 d	Chest and neck pain suggestive of angina, initial hsTnT 4 ng/L. AMI excluded. Diagnosed with aneurysmal subarachnoid hemorrhage in ED and subsequently died.
5	Noncardiac death < 90 d	Known hepatocellular carcinoma and chest pain. Discharged after AMI ruled out. Readmitted 6 wk later with fulminant liver failure and hepatorenal syndrome. Died in hospital.

AMI = acute myocardial infarction; hsTnT = high‐sensitivity cardiac troponin T; MI = myocardial infarction; PCI = percutaneous coronary intervention.

^aTwenty‐four other patients had an initial hsTnT < 6 ng/L on ED arrival and underwent revascularization within 90 days. None of these patients died or had a diagnosis of AMI.