Prognostic Implications of Low Level Cardiac Troponin Elevation Using High‐Sensitivity Cardiac Troponin T

ABSTRACT Background High‐sensitivity cardiac troponin T (hsTnT) is used in many countries, but is not available in the United States. Prior evidence has been viewed as inconclusive as to whether low cardiac troponin T (cTnT) concentrations detected with hsTnT are prognostically meaningful compared with fourth‐generation cTnT. Hypothesis The aim of this study was to assess the prognostic performance of low‐level cTnT elevations using the hsTnT assay compared with the assay (fourth‐generation) currently available in the United States. Methods We measured serum cTnT in 4160 patients with non–ST‐elevation acute coronary syndrome using both the hsTnT and fourth‐generation assays. Patients were stratified at the 99th percentile cut point for each assay. Results Patients with baseline hsTnT ≥14 ng/L (n = 3697) vs