On 2014 Aug 28, Frederick K Korley commented:

Agreed. Troponin values can no longer be used in a dichotomous fashion. Any troponin elevation is a bad troponin elevation. However, those without acute elevations may not necessarily need inpatient hospitalization. If they are discharged, they will benefit from expedited outpatient follow-up.

On 2014 Aug 27, Ryan Radecki commented:

Post-publication commentary:

"Highly Sensitive Troponins – False Positive Bonanza"

The “highly sensitive” troponin has received a great deal of publicity, hyped ad nauseum, see: “Simple test could help rule out heart attacks in the ER.”

But, as sensitivity increases – invariably, specificity decreases. However, that is not the fault of the test – it is a failure of clinicians to ask the correct question of the test. When asking “does this patient have an acute myocardial infarction?”(most commonly Type 1 MI in the ED), our training and education has been outpaced by assay technology – the test no longer provides a dichotomous “yes” or “no”.

http://www.emlitofnote.com/2014/08/highly-sensitive-troponins-false.html

On 2014 Aug 27, Ryan Radecki commented:

Post-publication commentary:

"Highly Sensitive Troponins – False Positive Bonanza"

The “highly sensitive” troponin has received a great deal of publicity, hyped ad nauseum, see: “Simple test could help rule out heart attacks in the ER.”

But, as sensitivity increases – invariably, specificity decreases. However, that is not the fault of the test – it is a failure of clinicians to ask the correct question of the test. When asking “does this patient have an acute myocardial infarction?”(most commonly Type 1 MI in the ED), our training and education has been outpaced by assay technology – the test no longer provides a dichotomous “yes” or “no”.

http://www.emlitofnote.com/2014/08/highly-sensitive-troponins-false.html

On 2014 Aug 28, Frederick K Korley commented:

Agreed. Troponin values can no longer be used in a dichotomous fashion. Any troponin elevation is a bad troponin elevation. However, those without acute elevations may not necessarily need inpatient hospitalization. If they are discharged, they will benefit from expedited outpatient follow-up.