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November 1, 1995

Cardiac Troponin T and Point-of-Care Testing for Myocardial Infarction

Author Affiliations

Wayne State University School of Medicine Detroit, Mich

JAMA. 1995;274(17):1343-1344. doi:10.1001/jama.1995.03530170023018

To the Editor.  —Despite their obvious enthusiasm for point-of-care testing for cardiac troponin T (cTnT), Dr Antman and colleagues1 have not provided convincing evidence that this technology is either applicable or appropriate in the clinical setting. Many of the arguments used to justify using a test with a false-positive rate of 35% and a sensitivity ranging rom only 33% to a maximum of 86% are paper tigers. The time needed to perform creatine kinase (CK), CK-MB, and troponin assays on modern random-access chemistry and immunochemistry analyzers is as little as 17 minutes in the clinical laboratory, not 2 hours as the authors cited. Moreover, recent studies2,3 comparing immunoassays for cardiac troponin (troponin T or I) with CK-MB show similar sensitivity of cardiac troponin to CK-MB for detection of acute mycocardial infarction. According to these studies, in the laboratory setting there was also an increased specificity for myocardial damage

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