| Sumario: | Keywords: Editorials; biomarkers; research; troponin EN Editorials biomarkers research troponin 2225 2228 4 06/10/21 20210608 NES 210608 B Article, see p 2214 b Over the past 3 decades, cardiac troponin (cTn) I and T have evolved as the preferred biomarkers for the detection of myocardial injury and in the appropriate setting to support the diagnosis of acute myocardial infarction (MI).[1] Almost all of the early data in this field were derived from observational studies including multiple key secondary analyses from acute coronary syndrome trials supporting their use.[2] Over time, analytic advancements brought by high-sensitivity (hs) cTn assays enabled the reliable measurement of very low cTn concentrations that allowed the development of various MI risk stratification approaches. This is an important feature and advantage of pragmatic RCTs as compared with traditional RCTs, which generally require patient-level informed consent, reducing generalizability and the ability to recruit an all-comers population, including the more critically ill patients who need more emergent care. One such strategy is the use of a single very low measurement of hs-cTn in patients with a nonischemic ECG to identify patients unlikely to have acute MI.
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