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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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