Uniform or Sex-Specific Cardiac Troponin Thresholds to Rule Out Myocardial Infarction at Presentation
Authors' conclusion
Implementation of a uniform rule-out threshold for myocardial infarction was safe and effective in both sexes.
Study context
- Population
- Consecutive patients presenting with possible MI46% female
- Participants
- 16,792 patients
- Exposure
- Uniform rule-out threshold (<5 ng/L) vs sex-specific thresholds of high-sensitivity cardiac troponin I
- Outcome
- Proportion of low-risk patients discharged from the ED and incidence of MI or cardiac death
- Follow-up
- 30 days
Methodological detailsconsecutive patients, derivation and validation of sex-specific thresholds
- Consecutive patients
- Derivation and validation of sex-specific thresholds
Main finding
As reported in the abstract
Uniform threshold: identified as low risk
Uniform threshold: identified as low risk
Low-risk discharged from ED
- Low-risk patients with subsequent MI or cardiac death at 30 days
- fewer than 5 (<0.1%)
Observational data: associations, not effects.
Further findings
Identified as low risk: uniform threshold (<5 ng/L) vs sex-specific thresholds
Uniform threshold
Sex-specific thresholds
Original publication
Uniform or Sex-Specific Cardiac Troponin Thresholds to Rule Out Myocardial Infarction at Presentation. J Am Coll Cardiol. Published 25 March 2024. doi:10.
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