Assessment of high sensitivity cardiac Troponin T assay for the rapid diagnosis of acute coronary syndrome and acute myocardial infarction in the emergency room a review of the clinical and economic evidence

Summary: The acute coronary syndromes (ACS) encompass a spectrum of unstable coronary artery disease from unstable angina to transmural myocardial infarction. Their common aetiology is the formation of thrombus on an inflamed and complicated atheromatous plaque. Acute myocardial infarction (AMI) reflects a state of acute myocardial necrosis. It was estimated that in 2004 there were 1,565,000 hospitalizations for primary or secondary diagnosis of an acute coronary syndrome (ACS), 669,000 for unstable angina and 896,000 for myocardial infarction in USA. Despite the reduction of coronary heart disease mortality over the past 40 years, hospital admissions for acute coronary syndromes (ACS) continue to increase. The rapid and reliable diagnosis of acute myocardial infarction is a major unmet clinical need. Failure to identify patients with ACS is a serious clinical problem.