Implications for practice and future research
sepsis, myocardial infarction, myocardial injury, non-ischaemic myocardial injury
PULMONARY EMBOLISM, MYOCARDIAL INFARCTION, SARS-COV-2 INFECTION, RENAL FAILURE, TYPE 1 MYOCARDIAL INFARCTION, HEART FAILURE, SEPSIS, MYOCARDIAL ISCHAEMIA
In practice, myocardial infarction is differentiated from other mechanisms of myocardial injury by the presence of symptoms or signs of myocardial ischaemia, or by definitive cardiac imaging. Patients with an adjudicated diagnosis of myocardial infarction who were reclassified by the high sensitivity assay in standard care, but with the results concealed, may already have been recognised as being at increased risk or in need of further assessment owing to symptoms or electrocardiographic findings. As such, there was perhaps less to gain from recognising these patients as having elevated cardiac troponin levels after high sensitivity testing, unlike those with non-ischaemic myocardial injury that may be silent and only identified by troponin testing.Cardiac troponin is now widely recognised as a powerful independent prognostic marker in patients without type 1 myocardial infarction across a diverse range of acute cardiac and non-cardiac conditions, such as sepsis, renal failure, pulmonary embolism, heart failure, after surgical interventions, and, more recently, in patients with SARS-CoV-2 infection.