High-Sensitivity Cardiac Troponin for the Exclusion of Inducible Myocardial Ischemia in Symptomatic Patients
Authors: Joan Walter, Christian Mueller
Journal: Annals of Internal Medicine (2020)

Letters7 July 2020High-Sensitivity Cardiac Troponin for the Exclusion of Inducible Myocardial Ischemia in Symptomatic PatientsJoan Walter, MD, PhD and Christian Mueller, MDJoan Walter, MD, PhDCardiovascular Research Institute Basel, University Hospital Basel, and University of Basel, Basel, Switzerland (J.W., C.M.)Search for more papers by this author and Christian Mueller, MDCardiovascular Research Institute Basel, University Hospital Basel, and University of Basel, Basel, Switzerland (J.W., C.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0261 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Kim and colleagues for their attempt to explain the different findings observed in our respective studies (1). We fully agree that differences in patient population may have contributed to the observed variations in NPV. However, the fact that our study focused on patients with symptomatic rather than asymptomatic CAD is of major clinical relevance. In patients with symptomatic CAD, hs-cTnI cutoffs even lower than 2.5 ng/L fail to accurately exclude inducible myocardial ischemia. Similarly, even in subgroups of patients with symptomatic CAD with similar or even lower pretest probability of inducible myocardial ischemia than the ...Reference1. Hammadah M, Kim JH, Tahhan AS, et al. Use of high-sensitivity cardiac troponin for the exclusion of inducible myocardial ischemia. A cohort study. Ann Intern Med. 2018;169:751-760. [PMID: 30398528]. doi:10.7326/M18-0670 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Cardiovascular Research Institute Basel, University Hospital Basel, and University of Basel, Basel, Switzerland (J.W., C.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0080. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUsing High-Sensitivity Cardiac Troponin for the Exclusion of Inducible Myocardial Ischemia in Symptomatic Patients Joan Walter , Jeanne du Fay de Lavallaz , Luca Koechlin , Tobias Zimmermann , Jasper Boeddinghaus , Ursina Honegger , Ivo Strebel , Raphael Twerenbold , Melissa Amrein , Thomas Nestelberger , Desiree Wussler , Christian Puelacher , Patrick Badertscher , Michael Zellweger , Gregor Fahrni , Raban Jeger , Christoph Kaiser , Tobias Reichlin , and Christian Mueller High-Sensitivity Cardiac Troponin for the Exclusion of Inducible Myocardial Ischemia in Symptomatic Patients Jeong Hwan Kim , Muhammad Hammadah , Viola Vaccarino , and Arshed A. Quyyumi Metrics 7 July 2020Volume 173, Issue 1Page: 77KeywordsAttentionDecision makingDisclosureForecastingHeart failureHigh sensitivity cardiac troponinIschemiaMyocardial infarctionNegative predictive value ePublished: 7 July 2020 Issue Published: 7 July 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...