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We thank Jaffe and Apple (1) for their interest in our study. In their perspectives article, they commented on details of our study and the study by Keller et al., which were both published recently in the New England Journal of Medicine (2)(3). Although we fully agree with several of their statements, we strongly disagree with others. It is detrimental to the much-needed interdisciplinary discussion on the best possible clinical use of sensitive cardiac troponin assays when the discussion is based on incorrect statements. Unfortunately, the Jaffe and Apple perspective contains 2 important errors.First, and of most importance, Jaffe and Apple (1) asked, “How did these studies deal with the problem of increased [cardiac troponin] concentrations produced [by diseases other than acute myocardial infarction (AMI)1 ]?” and stated, “Not very well. For the most part, the authors … used a [cardiac troponin] concentration above the cutoff value as the sole criterion for the diagnosis …

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