Implementation of a Sensitive Troponin I Assay and Risk of Recurrent Myocardial Infarction and Death in Patients With Suspected Acute Coronary Syndrome Increasing the sensitivity of troponin assay can improve early diagnosis of myocardial infarction Only values at or above the diagnostic threshold of 0.20 ng/mL Provide assess to better intervention for patients with suspected acute coronary syndrome Determine the effect of sensitive assay on the rate diagnosis of MI Whether small increases in troponin predict the future risk of adverse clinical outcomes How lowering the diagnostic thresholds would affect clinical outcomes Original diagnostic threshold was 0.20 ng/mL with laboratory coefficient of variation of = 0.20 ng/mL were reported Implementation period: February 1 to July 31, 2010 Concentrations above >= 0.05 ng/mL were reported in the implementation phase 3434 patients met the inclusion criteria but 1342 patients had at least 1 exclusion criteria Total study population was 2092 patients Inclusion criteria: Symptoms of chest pain of suspected cardiac origin measurement of plasma troponin I concentration on admission Exclusion criteria: Noncardiac chest pains Tachyarrhythmia Anemia Severe valvular heart disease Pericarditis Cocaine use The increase sensitivity allowed for the detection of MI by 29% Identified patients who were at highest risk of recurrent MI and death Lowering the diagnostic threshold allowed for 50% reduction in the rate of death or recurrent MI in the subgroup of patients Patients are from a homogenous population