II. Epidemiology

  1. Sensitivity: 100% of Myocardial Infarctions
  2. Specificity: Low (36% have Unstable Angina)
    1. See Troponin for false possible causes

III. Labs: Timing Following Acute Myocardial Infarction

  1. Serum levels increase within 4-8 hours of MI onset
  2. Serum levels peak at 12 to 48 hours
  3. Serum levels are elevated for 4-10 days after MI

IV. Advantages

  1. More specific than Troponin T
  2. Not falsely elevated in Chronic Renal Failure

V. Technique: ED Acute Coronary Syndrome evaluation

  1. Obtain 2 Troponin values 6 hours apart

VI. Interpretation

  1. Level >1.0 to 1.2 suggestive of Myocardial Infarction
  2. Two negative values 3-6 hours apart
    1. Predicts low likelihood of Acute Coronary Syndrome

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