Small Changes in Cardiac Troponin Levels Are Common in Patients with Myocardial Infarction: Diagnostic Implications

Changes in cardiac troponin (cTn) levels are often evaluated when myocardial infarction (MI) is suspected. The change in the troponin level required for diagnosis is being debated but should exceed the natural biological variation according to current guidelines. Despite this, several reports show that MI patients often present at the emergency ward with relatively stable cTn elevations. In this review we discuss the potential problem using a small cTn change as a way to exclude MI and also provide a possible solution to this diagnostic problem using long-term cTn change.