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Response: a novel troponin I rule-out value below the upper reference limit for acute myocardial infarction
  1. Andrew R Chapman,
  2. Atul Anand,
  3. Anoop S V Shah,
  4. Philip D Adamson,
  5. Nicholas L Mills
  1. BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Andrew R Chapman, BHF/University Centre for Cardiovascular Science, University of Edinburgh, Room SU305, Chancellor's Building, Edinburgh EH16 4SB, UK; A.R.Chapman{at}

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To the Editor,

Goorden et al aim to establish the optimal threshold to rule out myocardial infarction using a high-sensitivity cardiac troponin I assay. They report that a cardiac troponin I concentration <10 ng/L or a change of <20 ng/L on serial testing had a negative predictive value for the diagnosis of myocardial infarction of 99.8% and 98.7%, respectively.1 While we agree that there are better approaches to rule out myocardial infarction than using the 99th centile upper reference limit,2 ,3 we have several …

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  • Funding British Heart Foundation Special Project Grant (SP/12/10/29922), Project Grant (PG/15/51/31596) and Senior Clinical Research Fellowship (FS/16/14/32023), Edinburgh and Lothians Health Foundation Research Fellowship (50-534).

  • Competing interests AA has received speaker fees from Abbott Laboratories. ASVS has acted as a consultant for Abbott Laboratories. NLM has acted as a consultant for Abbott Laboratories, Beckman-Coulter, Roche and Singulex.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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