A 62-year-old woman presents to the emergency department with central chest pain that began one hour earlier. Her medications include aspirin, lisinopril, and atorvastatin. Her heart rate is 110 beats/min, blood pressure is 140/90 mm Hg, and pulse oximetry is 98 percent. Electrocardiography shows sinus rhythm and nonspecific ST-T changes. Which of the following measurements using the new, highly sensitive cardiac troponin (cTn) assays provides the BEST diagnostic accuracy for acute myocardial infarction (AMI)?

The early diagnosis of AMI is crucial for improving patient outcomes. AMI can be diagnosed on the basis of symptoms, electrocardiographic (ECG) changes, biomarkers of cardiac necrosis, and cardiac imaging. ST elevation myocardial infarction can be readily identified by the characteristic ECG changes. However, diagnosing AMI when confronted with nonspecific ECG changes can be challenging.

Cardiac troponins (cTn) are promptly released into the bloodstream following myocardial necrosis, but they do not elucidate the mechanism of myocardial...

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