Things ain't what they used to be: Impact of a new definition of myocardial infarction

Microvascular obstruction after plaque rupture. Despite recurrent micro emboli, the levels of CK-MB do not reach the diagnostic threshold, whereas because of the long half life and higher sensitivity of the assays, the diagnostic threshold for troponin is reached. CK-MB, Creatine kinase-MB. Adapted with permission from: Goldman BU, Christenson RH, Hamm CW, et al. Implications of troponin testing in clinical medicine. Curr Control Trials Cardiovasc Med 2001;2:75-84.

Increasing risk in different clinical scenarios with the same troponin level. ACS, Acute coronary syndrome; CABG, coronary artery bypass grafting; LAD, left anterior descending coronary artery; LV, left ventricular; PCI, percutaneous coronary intervention.