Bedside Multimarker Testing for Risk Stratification in Chest Pain Units: The Chest Pain Evaluation by Creatine Kinase-MB, Myoglobin, and Troponin I (CHECKMATE) Study
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
To the Editor:
We wish to raise several questions about the article by Newby et al. 1 It purports to demonstrate that a quantitative multimarker strategy is better for chest pain patients than a single marker strategy because it identifies patients who are at risk for death earlier. (1) How would the results differ if the recent criteria advocated by the European Society of Cardiology (ESC) and the American College of Cardiology (ACC)2,3 were used [ie, the 99th percentile of the normal range or at a point with ≤10% imprecision 2–4]? (2) Because local values were used for the single marker strategy, were the cut points similar to those used by the Dade-Behring Stratus CS analyzer? It appears to us that had that been the case, more patients would have been detected earlier than reported, especially with the single marker troponin strategy. (3) How would a myoglobin, troponin standard …