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November 1, 1995

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

Author Affiliations

Brigham and Women's Hospital Boston, Mass

JAMA. 1995;274(17):1344. doi:10.1001/jama.1995.03530170023019

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In Reply.  —To our knowledge, our article is the first clinical report on the functional characteristics of the rapid cTnT assay. In addition to apparent misinterpretation of some of our statements, Drs Eisenbrey and Artiss raised concerns that are uncommonly harsh for the initial report of a new diagnostic test. Although they quote a false-positive rate of 35% for the rapid cTnT assay, the data contained in the Table in our article actually indicate false-positive rates of 5.3%, 0%, 0%, and 14.3% at 0 to 2, 2 to 4, 4 to 8, and more than 8 hours from the onset of chest pain, respectively. Furthermore, the concept of a false-positive result must be reconsidered when a more sensitive test for myocardial necrosis, such as cTnT, is compared with a "gold standard" of CK-MB, which is known to be insensitive to small infarcts. In addition, CK-MB may be increased in the

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