Keypoints
- Where clinical suspicion of MI is high (eg typical symptoms) refer immediately: do not test troponin
- Where clinical suspicion of MI is low (eg atypical symptoms or delayed presentation): troponin may be useful
- Negative troponin from the laboratory (measured at least 10 hours from onset of symptoms) can rule out almost all myocardial events
- Positive troponin (from either a laboratory or point-of-care) is an indication for immediate referral
- Troponin has no role as a screening test for cardiovascular disease (CVD)
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