Cutoff for high-sensitivity cardiac troponin T is not arbitrary but according to usual clinical practice

Abstract

We were pleased to read a comment written by Bianchi regarding our article previously published in The Journal of Thoracic and Cardiovascular Surgery. Bianchi raised several important issues related to the use of high-sensitivity cardiac troponin T (hs-cTnT) for the diagnosis of acute myocardial infarction (MI). First, we shall respond to his comment on the electrocardiographic and transthoracic echocardiographic approach. The combination of biomarkers with electrocardiographic or transthoracic echocardiographic criteria to diagnose perioperative MI, as suggested by the “Third Universal Definition of Myocardial Infarction,” is more specific and has a high negative predictive value for the diagnosis of perioperative MI after heart valve surgery than the use of a single criterion.