Can a single very low high-sensitivity troponin T result, combined with a non-ischaemic ECG, rule out myocardial infarction? Rick Body discusses a 2016 TRAPID-AMI analysis, its promising diagnostic performance and why excluding infarction does not automatically make discharge appropriate.
One high sensitivity troponin test to rule out acute myocardial infarction Read More
Could a single high-sensitivity troponin I result help rule out acute coronary syndrome at presentation? This 2015 appraisal examines a diagnostic cohort study, distinguishing negative predictive value from sensitivity and asking how the findings fit with ECG interpretation, clinical risk and different patient populations.
JC: High sensitivity Troponin I on presentation. Is it enough to rule out ACS? St.Emlyn’s Read More
How much does describing chest pain as ‘typical’ tell us about the final diagnosis? Simon Carley reviews a 2015 observational study of clinician judgement, questioning the value of experience alone and examining how patient selection, specificity and the presentation of diagnostic performance affect interpretation.
JC: Are typical chest pain symptoms predictive of outcome? St.Emlyn’s Read More
Does more severe chest pain make a heart attack more likely? Rick Body describes a 2014 study of emergency department patients, showing the difference between a statistically significant association and a useful diagnostic test, and why mild discomfort alone cannot provide reassurance about the underlying cause.
Is severe chest pain more likely to be a heart attack? Read More
Rick Body examines NICE’s 2014 recommendations on high-sensitivity troponin testing for early exclusion of NSTEMI. The article and podcast explain the guidance’s limited assay-specific scope, the distinction between excluding infarction and deciding on discharge, and the practical challenge of fitting repeat testing into emergency department workflows.
New NICE high sensitivity troponin guidance: 3 hours and done? Read More
Louise Cullen and Rick Body debate whether high-sensitivity troponin is friend or foe at SMACC Gold 2014. This post brings together the recording, both speakers’ slides and background resources on troponin interpretation, including why a raised concentration does not always mean acute myocardial infarction.
The Troponin Ashes at SMACC Gold: Cullen v Body Read More
What does ‘high sensitivity’ actually mean when describing a troponin assay? This 2014 explainer and accompanying podcast unpack detection limits, precision and the distinction between analytical and diagnostic sensitivity, while exploring why more sensitive tests still require careful clinical interpretation.
High sensitivity troponin Read More
A 2014 introduction to cardiac troponin, built around common questions from the emergency department. The post introduces Rick Body and Iain Beardsell’s podcast on interpreting results, including causes of elevation, timing, changes between samples and the complications posed by renal failure.
Cardiac Troponin: The basics from St. Emlyn’s Read More
