Acute Myocardial Infarction
Authors: Sukhchain Singh, Amandeep Singh, Sandeep Khosla
Journal: Annals of Internal Medicine (2015)

Letters21 July 2015Acute Myocardial InfarctionSukhchain Singh, MD, Amandeep Singh, MD, and Sandeep Khosla, MDSukhchain Singh, MDFrom Ingalls Memorial Hospital, Harvey, Illinois; Sanford Medical Center, Thief River Falls, Minnesota; and Mount Sinai Hospital Medical Center and Rosalind Franklin University of Medicine and Science, Chicago, Illinois.Search for more papers by this author, Amandeep Singh, MDFrom Ingalls Memorial Hospital, Harvey, Illinois; Sanford Medical Center, Thief River Falls, Minnesota; and Mount Sinai Hospital Medical Center and Rosalind Franklin University of Medicine and Science, Chicago, Illinois.Search for more papers by this author, and Sandeep Khosla, MDFrom Ingalls Memorial Hospital, Harvey, Illinois; Sanford Medical Center, Thief River Falls, Minnesota; and Mount Sinai Hospital Medical Center and Rosalind Franklin University of Medicine and Science, Chicago, Illinois.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5113 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:High-sensitivity troponin assays are proving to be a costly problem facing internists in hospital medicine practice and such payers as Medicare. High-sensitivity troponin assays, when used in proper clinical context, are useful and increase the accuracy of diagnosing myocardial infarction (MI). Shroff (1) correctly highlights the higher mortality associated with and lack of evidence-based treatment options for type 2 MI or elevated troponin levels without treatable intracoronary lesions or obstruction. There is no sound empirical evidence to support risk stratification based on troponin assays or their routine use to rule out or rule in MI when patients ...References1. Shroff GR. Acute myocardial infarction: what's in a name? Ann Intern Med. 2015;162:448-9. [PMID: 25775318] doi:10.7326/M14-2259 LinkGoogle Scholar2. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al; Joint ESC/ACCF/AHA/WHF Task Force for Universal Definition of Myocardial Infarction. Third universal definition of myocardial infarction. J Am Coll Cardiol. 2012;60:1581-98. [PMID: 22958960] doi:10.1016/j.jacc.2012.08.001 CrossrefMedlineGoogle Scholar3. Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al; ACC/AHA Task Force Members. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;130:e344-426. [PMID: 25249585] doi:10.1161/CIR.0000000000000134 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Sukhchain Singh, MD; Amandeep Singh, MD; Sandeep Khosla, MDAffiliations: From Ingalls Memorial Hospital, Harvey, Illinois; Sanford Medical Center, Thief River Falls, Minnesota; and Mount Sinai Hospital Medical Center and Rosalind Franklin University of Medicine and Science, Chicago, Illinois.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0277. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAcute Myocardial Infarction: What's in a Name? Gautam R. Shroff Acute Myocardial Infarction: What's in a Name? Gautam R. Shroff Acute Myocardial Infarction Gautam R. Shroff Acute Myocardial Infarction Gautam R. Shroff Metrics Cited byFactors associated with microvascular occlusion in patients with ST elevation myocardial infarction after primary percutaneous coronary intervention 21 July 2015Volume 163, Issue 2Page: 151-152KeywordsDisclosureEmergency departmentHospital medicineMedical risk factorsMedicareMortalityMyocardial infarctionMyocardiumThrombosisTroponin ePublished: 21 July 2015 Issue Published: 21 July 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...