Troponin testing for detection of acute myocardial infarction in skeletal muscle disease patients: Follow the guidelines

摘要

In a recent letter to the editor of the Journal (1), Rittoo describes what he calls a "fundamental error" in the guidance documents on the diagnosis of acute myocardial infarction (AMI), namely, in the universal definition of AMI (2) and the expert consensus (3), with potential implications for the detection of AMI during increased skeletal muscle repair or disease events. In particular, Rittoo infers from 3 references (4-6), with overlapping authorship, that diseased skeletal muscle may re-express cardiac troponin T (cTnT), but not cTnl, which may then lead to elevated cTnT in serum. The author further states that the guidance documents wrongly define elevations of the marker in the circulation as "virtually diagnostic of mvocardial necrosis."