{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:57:54Z","timestamp":1791194274218,"version":"4.1.0"},"reference-count":38,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[2003,3]]},"abstract":"<jats:p>\n                  <jats:bold>Objective:<\/jats:bold> To assess the diagnostic efficiency of the third generation cardiac troponin T assay in routine clinical practice.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Design:<\/jats:bold> Prospective observational study of unselected consecutive admissions.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Setting:<\/jats:bold> Multicentre study in 43 teaching and non-teaching hospitals in 13 countries.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Subjects:<\/jats:bold> 1105 hospital admissions, median age 67 years (range 15\u201396 years, 63.7% male) with suspected acute coronary syndromes (72.3% of cases) or other non-specific symptoms where cardiac disease required exclusion (27.7%).<\/jats:p>\n               <jats:p>\n                  <jats:bold>Interventions:<\/jats:bold> Over the study period, myoglobin, creatine kinase MB isoenzyme (CK-MB), and cardiac troponin T where measured in parallel with conventional diagnostic tests. Final diagnostic classification involved standard ECG changes and CK-MB mass exceeding 5.0 \u03bcg\/l.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Main outcome measures:<\/jats:bold> Diagnostic efficiency was assessed by receiver operator characteristic curve analysis including and excluding patients with unstable angina.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results:<\/jats:bold> Measurement of cardiac troponin T was diagnostically equivalent to CK-MB and both were better than myoglobin, with areas under the curve at 12 hours of 0.94, 0.99, and 0.80, respectively. Diagnostic criteria using CK-MB were inadequate and showed bias when patients with unstable angina were included. Elevations of cardiac troponin T did not occur when cardiac disease could be categorically excluded but were found in clinical conditions other than suspected acute coronary syndromes.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusions:<\/jats:bold> CK-MB is unsuitable as a diagnostic gold standard even at the proposed lower threshold. A lower cut off for cardiac troponin T of 0.05 \u03bcg\/l should be used for diagnosis of acute myocardial infarction. Diagnosis of acute myocardial infarction cannot be made solely on the basis of a cardiac troponin T result.<\/jats:p>","DOI":"10.1136\/heart.89.3.280","type":"journal-article","created":{"date-parts":[[2003,2,18]],"date-time":"2003-02-18T15:43:45Z","timestamp":1045583025000},"page":"280-286","source":"Crossref","is-referenced-by-count":67,"title":["Multicentre evaluation of the diagnostic value of cardiac troponin T, CK-MB mass, and myoglobin for assessing patients with suspected acute coronary syndromes in routine clinical practice"],"prefix":"10.1136","volume":"89","author":[{"given":"P O","family":"Collinson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P 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