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Mills NL, Churchhouse AMD, Lee KK et al. JAMA 2011;305:1210–6.

In this study, the authors assessed whether a more sensitive troponin assay can improve clinical outcomes in patients with ACS. A lower diagnostic threshold for plasma troponin increased the rate of diagnosis of myocardial infarction (MI), and identified patients who were at high risk of recurrent MI or death. Thus, major reductions in the risk of morbidity and mortality were achieved using the assay.


Troponin assays have become increasingly sensitive over time. However, whether lowering the threshold for the detection of plasma troponin improves clinical outcomes in patients with suspected ACS is unknown. The aim of this study was to assess the following:

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