Clinical impact of the troponin 99th percentile cut-off and clinical utility of myoglobin measurement in the early management of chest pain patients admitted to the Emergency Cardiology Department.

Methods A total of 516 consecutive non-ST-elevation patients admitted to hospital were followed. The first measurement of cardiac markers was performed at the point-of-care in the Emergency Cardiology Department, using Stratus CS. The lowest cardiac troponin I concentration with a CVr10% (cardiac troponin I concentration = 0.07 lg/l) was used to perform an early diagnosis of cardiac damage and to admit non-ST-elevation patients to the Intensive Cardiac Unit. Final diagnosis of acute myocardial infarction was assessed according to European Society of Cardiology and American College of Cardiology diagnostic criteria: cardiac marker follow-up after hospital admission was performed in central laboratory. We retrospectively assessed how the diagnostic accuracy of an early diagnosis of myocardiac damage in the same population might have changed if different lower cardiac troponin I cut-offs had been used upon admitting patients in the Emergency Cardiology Department, independently from the analytical imprecision of the method.