Early Dynamic Change in High-Sensitivity Cardiac Troponin T in the Investigation of

farction (AMI) requires a rise and/or fall in troponin with 1 ormore results!99th percentile of the reference range. How much troponin must change has not been specified. We ascertained whether dynamic changes (") in high-sensitivity troponin T (hs-TnT) improved diagnostic and prognostic test performance in the emergency department. METHODS: We recruited 939 patients with symptoms suggestive of acute coronary syndrome (without ST elevation). hs-cTnT was measured at 0 h and 2 h after presentation. End-points were admission diagnosis of AMI and 1-year adverse events (composite of death, AMI, revascularization). RESULTS: Diagnostic specificity of 0–2-h hs-cTnT for AMI (incurred by 200 patients) improved from 79.8