Early Diagnosis of Myocardial Infarction Using Absolute and Relative Changes in Cardiac Troponin Concentrations Affan Irfan, MD, Tobias Reichlin, MD,

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Early Diagnosis of Myocardial Infarction Using Absolute and Relative Changes in Cardiac Troponin Concentrations Affan Irfan, MD, Tobias Reichlin, MD, Raphael Twerenbold, MD, Marc Meister, MD, Berit Moehring, MD, Karin Wildi, MD, Stefano Bassetti, MD, Christa Zellweger, MD, Maria Rubini Gimenez, MD, Rebeca Hoeller, MD, Karsten Murray, MD, Seoung Mann Sou, MD, Mira Mueller, MD, Tamina Mosimann, MD, Miriam Reiter, MD, Philip Haaf, MD, Ronny Ziller, MD, Heike Freidank, MD, Stefan Osswald, MD, Christian Mueller, MD The American Journal of Medicine Volume 126, Issue 9, Pages 781-788.e2 (September 2013) DOI: 10.1016/j.amjmed.2013.02.031 Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 1 Two-hour absolute (A, D, G), relative (B, E, H), and the combination of both (C, F, I) changes in hs-cTnT: Roche Diagnostics Corporation (Indianapolis, Ind) (top); hs-cTnI: Beckman Coulter Inc (Brea, Calif) (middle); hs-cTnI: Siemens (Munich, Germany) (bottom). Patients with acute myocardial infarction are shown on the right in green, and patients with other causes of chest pain are shown on the left in blue. hs-cTnI = high-sensitivity cardiac troponin I; hs-cTnT = high-sensitivity cardiac troponin T. The American Journal of Medicine 2013 126, 781-788.e2DOI: (10.1016/j.amjmed.2013.02.031) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 2 AUC of the 2-hour absolute changes, relative changes alone, and the combination of both changes in all patients for hs-cTnT, Roche (A); hs-cTnI, Beckman Coulter (B); hs-cTnI, Siemens (C); and in subgroup of patients with an elevated baseline hs-cTn level (with the relative change >20% shown on the graph) (D, E, F). The American Journal of Medicine 2013 126, 781-788.e2DOI: (10.1016/j.amjmed.2013.02.031) Copyright © 2013 Elsevier Inc. Terms and Conditions