[Improved diagnostics of myocardial infarction with troponins. International guidelines should be observed]

The American College of Cardiology and the European Society of Cardiology have recently published new guidelines on the diagnosis of acute myocardial infarction. These guidelines emphasize the importance of biochemical markers for diagnosis, and define standards for the quality of laboratory methods and decision limits. Each laboratory method in clinical routine use should be described in a peer-reviewed medical publication, the coefficient of variation should be < 10% in a normal reference population, and the decision level for myocardial injury should be set at the 99th percentile. Blood sampling should be individualized with regard to the onset of symptoms. Analysis of a troponin should be the standard method. If these guidelines become generally accepted the diagnostic accuracy of the methods will be improved and important prognostic information will be gained.