TROPONIN AND THE NEW DEFINITION OF MYOCARDIAL INFARCTION
Abstract:
In 2000, the diagnosis criteria of myocardial infarction were redefined. The new definition recognizes the fact that neither anamnesis, nor electrocardiographic changes have sufficient sensibility or specificity. In the centre of the new definition, there is the utility of troponin for detecting the myocitary necrosis. The new definition brought to a dramatic increase of the cases of myocardial infarction. The increased level of troponin is now the most used marker for selecting patients with acute coronary syndrome without ST elevation for coronarography. The interest for an early determination of the myocardial injury has increased. As long as clinicians will be more familiarized with the testing, troponins will dethrone the role of creatinkinases regarding the diagnosis, but also the reperfusion, the re-infarction and the estimation of the infarction proportions. There are also cases of false positive results, but a good clinical assessment, together with a follow-up of the level of troponin, will orientate the diagnosis. This new definition sustains the necessity of dosing the troponin.
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