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Response to: ‘Convalescent troponin and cardiovascular death following acute coronary syndrome’ by Kawada
  1. Philip D Adamson1,2,
  2. Nicholas L Mills1,
  3. David E Newby1,
  4. Richard W Troughton2,
  5. Rob N Doughty3,
  6. A Mark Richards2
  1. 1 BHF Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
  2. 2 Christchurch Heart Institute, University of Otago Christchurch, Christchurch, New Zealand
  3. 3 Department of Medicine, University of Auckland, Auckland, New Zealand
  1. Correspondence to Dr Philip D Adamson, BHF Centre for Cardiovascular Sciences, The University of Edinburgh, Edinburgh EH16 4SU, UK; Philip.adamson{at}

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The Authors’ reply: We thank the author for their interest in our report documenting the long-term prognostic importance of convalescent cardiac troponin concentrations.1

First, we agree that when used for risk stratification low cardiac troponin concentrations miss fewer events than applying the sex-specific 99th centile upper reference limit as a single threshold, and indeed we identified the lower troponin threshold of 5 ng/L to be associated with a 5-year negative predictive value for cardiovascular death of 97.1% (95% CI 95.5 to …

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  • Contributors PDA drafted the letter. All authors contributed to revision of the letter.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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