Dr Evangelos Giannitsis
Cardiologist, Medical Director of Chest Pain Unit, University Hospital of Heidelberg, Germany
Dr Hugo Katus
Medical Director, Dept. of Cardiology, Angiology, and Pneumology, Heidelberg University Hospital, Germany

Serial testing of hs cTn rules out low risk of AMI


  • hs-TnT change may be able to rule out low risk of AMI
  • Serial hs- Tn needs to be done to make the final diagnosis of AMI
  • Diagnosis of AMI should take into consideration the entire clinical context
Clinical case 2

What is the diagnosis of this case?


Unstable angina pectoris with typical signs and symptoms, typical risk factors for coronary heart disease (CHD), normal 12-lead ECG, no indicative laboratory changes. The cTnT-hs concentration was repeatedly below the 99 percentile cut-off value (<14 ng/L).

Coronary angiography revealed several significant sub-occlusive stenoses of the right coronary artery (RCA)


There is no rise or fall in cTnT-hs values needed for AMI diagnosis.

  1. DOI: 10.1161/01.CIR.73.3.418
  2. Circulation, 1985 Apr;71(4):699-708. doi: 10.1161/01.cir.71.4.699

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