High-Sensitivity Troponin Offers AMI Diagnostic Edge

This multicenter pre-post cohort study was conducted across 16 Kaiser Permanente Southern California hospitals.
The study analyzed the data of 17,384 adult patients who presented to an ED with chest pain and underwent cardiac risk stratification with a HEART pathway using conventional troponin (cTn) or hsTn.
Among the 17,384 patients, 12,440 underwent cTn testing, whereas 4944 underwent hsTn testing.

The rate of AMI detection within 30 days was significantly higher in the hsTn vs cTn group (5.8% vs 4.4%; P <.001); however, the 30-day all-cause mortality rate was similar between the groups (P = .50).
In the ED, AMI diagnosis rates were significantly higher in the hsTn vs cTn group (4.6% vs 2.0%; P <.001).
However, within 30 days after the index ED visit, AMI diagnosis rates were significantly higher in the cTn vs hsTn group (2.4% vs 1.2%; P < .001).
In the hsTn vs cTn group, the rates of admission, stress testing within 7 days, and coronary revascularization within 30 days were significantly lower (all P <.001).

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