Coronary disease & ACSCohort study

Uniform or Sex-Specific Cardiac Troponin Thresholds to Rule Out Myocardial Infarction at Presentation

J Am Coll CardiolPublished

  • Cohort study
  • consecutive patients
  • derivation and validation of sex-specific thresholds

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
Female vs Male
Outcome
Proportion of low-risk patients discharged from the ED and incidence of MI or cardiac death
Follow-up
30 days

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:10.1016/j.jacc.2024.03.365

Summarised from the published abstract; every number is checked against it