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Quartile 1 Quartile 2 Quartile 3 Quartile 4 B cTnT Concentration

Fig. 3. (A) One-year and 30-d mortality in relation to quartiles of cTnT in FRISC-II study (dashed line) (13) and GUSTO-IV study (solid line) (15), respectively. (B) Rate of MI at 1 yr and 30 d in relation to quartiles of cTnT in FRISC-II study (dotted line) (13) and GUSTO-IV study (solid line) (15), respectively.

Patients with elevated troponin also have an increased risk of recurrent AMI (Table 2). However, in contrast to the graded increase in risk of death in relation to troponin concentration, there seems to be a nonmonotonic relationship for the risk ofa new MI (Fig. 3B). Indeed, the risk of suffering a new AMI seems to be higher in those with only minor elevations compared with those with major elevations of troponin (who may have completed the infarction in the territory at risk). Thus, a high analytic precision ofthe troponin assay at the low end of the detectable range is an attribute that is especially important for the prediction of AMI.

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