Hamm CW, Bassand JP, Agewall S, et al; ESC Committee for Practice Guidelines. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: the task force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2011;32:2999-3054. Abstract
Roffi M, Patrono C, Collet JP, et al; Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016;37:267-315. Abstract
Mueller C, Giannitsis E, Christ M, et al; TRAPID-AMI Investigators. Multicenter evaluation of a 0-Hour/1-Hour algorithm in the diagnosis of myocardial infarction with high-sensitivity cardiac troponin T. Ann Emerg Med. 2016;68:76-87. Abstract
Mueller M, Biener M, Vafaie M, et al. Absolute and relative kinetic changes of high-sensitivity cardiac troponin T in acute coronary syndrome and in patients with increased troponin in the absence of acute coronary syndrome. Clin Chem. 2012;58:209-218. Abstract
Reichlin T, Irfan A, Twerenbold R, et al. Utility of absolute and relative changes in cardiac troponin concentrations in the early diagnosis of acute myocardial infarction. Circulation. 2011;124:136-145. Abstract
Body R, Mueller C, Giannitsis E, et al; TRAPID-AMI Investigators. The use of very low concentrations of high-sensitivity troponin T to rule out acute myocardial infarction using a single blood test. Acad Emerg Med. 2016;23:1004-1013. Abstract
Mueller-Hennessen M, Mueller C, Giannitsis E, et al; TRAPID-AMI Investigators. Serial sampling of high-sensitivity cardiac troponin T may not be required for prediction of acute myocardial infarction diagnosis in chest pain patients with highly abnormal concentrations at presentation. Clin Chem. 2017;63:542-551. Abstract
Singer AJ, Than MP, Smith S, et al. Missed myocardial infarctions in ED patients prospectively categorized as low risk by established risk scores. Am J Emerg Med. 2017. doi: 10.1016/j.ajem.2017.01.003. [Epub ahead of print].
Boeddinghaus J, Nestelberger T, Twerenbold R, et al. Direct comparison of four very early rule-out strategies for acute myocardial infarction using high-sensitivity cardiac troponin I. Circulation. 2017;135:1597-1611. Abstract
Twerenbold R, Jaeger C, Rubini Gimenez M, et al. Impact of high-sensitivity cardiac troponin on use of coronary angiography, cardiac stress testing, and time to discharge in suspected acute myocardial infarction. Eur Heart J. 2016;37:3324-3332. Abstract
Peacock WF 4th, De Marco T, Fonarow GC, et al; ADHERE Investigators. Cardiac troponin and outcome in acute heart failure. N Engl J Med. 2008;358:2117-2126. Abstract
Vasudevan A, Singer AJ, DeFilippi C, et al. Renal function and scaled troponin in patients presenting to the emergency department with symptoms of myocardial infarction. Am J Nephrol. 2017;45:304-309. Abstract

CME / ABIM MOC / CE

Part III Lessons Learned: A Master Class in High-Sensitivity Troponin: A Global Perspective

Authors: James L. Januzzi, MD; Christian E. Mueller, MD; W. Frank Peacock, MD; Richard Body, MBChB, PhD
CME / ABIM MOC / CE Released: 5/15/2017
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 5/15/2019, 11:59 PM EST

Target Audience and Goal Statement

This activity is intended for cardiologists, emergency medicine physicians, primary care physicians, and nurses.

The goal of this activity is to assist clinicians in incorporating high-sensitivity cardiac troponin (hs-cTn) measurements into clinical care.

Upon completion of this activity, participants will:

Have increased knowledge regarding the
- Latest data on clinical use of hs-cTn
- Relationship between use of hs-cTn and patient outcomes
Have greater competence related to the
- Clinical application of high-sensitivity cardiac troponin

Disclosures

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

Moderator

James L. Januzzi, MD

Professor of Medicine, Division of Cardiology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts

Disclosures

Disclosure: James L. Januzzi, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Abbott Laboratories; Critical Diagnostics; Roche; Siemens AG
Received grants for clinical research from: Novartis Pharmaceuticals Corporation; Prevencio, Inc.; Roche; Singulex

Dr Januzzi does intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Januzzi does intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Panelists

Christian Mueller, MD

Professor of Cardiology; Director, Cardiovascular Research Institute Basel, Basel, Basel-Stadt, Switzerland

Disclosures

Disclosure: Christian Mueller, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Abbott Laboratories; Alere; AstraZeneca Pharmaceuticals LP; bioMérieux SA; Boehringer Ingelheim Pharmaceuticals, Inc.; Brahms; Bristol-Myers Squibb Company; Cardiorentis AG; Novartis Pharmaceuticals Corporation; Roche; Siemens AG; Singulex
Served as a speaker or a member of a speakers bureau for: Abbott Laboratories; Alere; AstraZeneca Pharmaceuticals LP; bioMérieux SA; Boehringer Ingelheim Pharmaceuticals, Inc.; Brahms; Bristol-Myers Squibb Company; Cardiorentis AG; Novartis Pharmaceuticals Corporation; Roche; Siemens AG; Singulex
Received grants for clinical research from: Abbott Laboratories; Alere; AstraZeneca Pharmaceuticals LP; Beckman Coulter, Inc.; bioMérieux SA; Brahms; Roche; Siemens AG; Singulex; sphingotec GmbH

Dr Mueller does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Mueller does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

W. Frank Peacock, MD

Professor of Emergency Medicine; Associate Chair and Research Director, Baylor College of Medicine, Houston, Texas

Disclosures

Disclosure: W. Frank Peacock, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Bayer Healthcare Pharmaceuticals; Beckman Coulter, Inc.; Instrumentation Laboratory; Janssen Pharmaceuticals, Inc.; Relypsa, Inc.; Roche; ZS Pharma
Received grants for clinical research from: Abbott Laboratories; Janssen Pharmaceuticals, Inc.; Roche; ZS Pharma Inc.
Owns stock, stock options, or bonds from: Ischemia Care
Other:
Owns by a commercial interest: Emergencies in Medicine

Dr Peacock does intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Peacock does intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Rick Body, MBChB, PhD

Professor, Royal College of Emergency Medicine, University of Manchester, Manchester, United Kingdom

Disclosures

Disclosure: Rick Body, MBChB, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Creavo Medical Technologies Ltd; FABPulous BV; Roche
Served as a speaker or a member of a speakers bureau for: Abbott Laboratories; Randox Laboratories Ltd.; Roche
Received grants for clinical research from: Abbott Point of Care

Dr Body does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Body does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Steering Committee

James L. Januzzi, MD

Professor of Medicine, Division of Cardiology, Harvard Medical School; Massachusetts General Hospital, Boston, Massachusetts

Disclosures

As listed above.

Javed Butler, MD, MBA, MPH

Professor of Medicine; Professor of Physiology and Biophysics; Director, Division of Cardiology; Co-Director, Heart Institute, Stony Brook University, Stony Brook, New York

Disclosures

Disclosure: Javed Butler, MD, MBA, MPH, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Amgen Inc.; AstraZeneca Pharmaceuticals LP; Bayer HealthCare Pharmaceuticals; CardioCell, LLC; CVRx, Inc.; Janssen Pharmaceuticals, Inc.; Luitpold Pharmaceuticals; Medtronic, Inc.; Novartis Pharmaceuticals Corporation; Relypsa, Inc.; ZS Pharma
Served as a speaker or a member of a speakers bureau for: Novartis Pharmaceuticals Corporation

Robert H. Christenson, PhD

Professor of Pathology; Professor of Medical and Research Technology, University of Maryland School of Medicine, Baltimore, Maryland

Disclosures

Disclosure: Robert H. Christenson, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Becton, Dickinson and Company; Roche; Siemens Healthcare Diagnostics Inc.
Served as a speaker or a member of a speakers bureau for: Roche; Siemens Healthcare Diagnostics Inc.
Received grants for clinical research from: Abbott Laboratories; Alere; Banyan Biomarkers, Inc.; Fujirebio Diagnostics, Inc.; Mitsubishi Chemical; Roche; Samsung; Siemens Healthcare Diagnostics Inc.

Lori B. Daniels, MD, MAS

Professor of Medicine, University of California, San Diego, La Jolla, California

Disclosures

Disclosure: Lori B. Daniels, MD, MAS, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Critical Diagnostics; Janssen Pharmaceuticals, Inc.; Roche
Other: Independent contractor, Siemens

Peter S. Pang, MD

Associate Professor of Emergency Medicine, Indiana University School of Medicine; Chief Science Officer, Indianapolis EMS, Indianapolis, Indiana

Disclosures

Disclosure: Peter S. Pang, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Bristol-Myers Squibb Company; Novartis Pharmaceuticals Corporation; Relypsa, Inc.; Roche; scPharmaceuticals, Inc.; Trevena, Inc.
Received grants for clinical research from: Novartis Pharmaceuticals Corporation; Roche

Editors

Joy P. Marko, MS, APN-C, CCMEP

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Joy P. Marko, MS, APN-C, CCMEP, has disclosed no relevant financial relationships.

Kalanethee Paul-Pletzer, PhD

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Kalanethee Paul-Pletzer, PhD, has disclosed no relevant financial relationships.

CME Reviewer/Nurse Planner

Amy Bernard, MS, BSN, RN-BC

Lead Nurse Planner, Medscape, LLC

Disclosures

Disclosure: Amy Bernard, MS, BSN, RN-BC, has disclosed no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships
Served as an advisor or consultant for: Abbott; HeartWare International, Inc; Medtronic, Inc; Thoratec Corporation

Accreditation Statements

In support of improving patient care, Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

For Physicians

Medscape, LLC designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

Contact This Provider

For Nurses

Awarded 0.50 contact hour(s) of continuing nursing education for RNs and APNs; none of these credits is in the area of pharmacology.

Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

Read the target audience, learning objectives, and author disclosures.
Study the educational content online or printed out.
Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

From Medscape Education Cardiology

CME / ABIM MOC / CE

Part III Lessons Learned: A Master Class in High-Sensitivity Troponin: A Global Perspective

Authors: James L. Januzzi, MD; Christian E. Mueller, MD; W. Frank Peacock, MD; Richard Body, MBChB, PhDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / ABIM MOC / CE Released: 5/15/2017

Valid for credit through: 5/15/2019, 11:59 PM EST

processing....

CME / ABIM MOC / CE Information Download Slides

Print
Like Tweet

Disclaimer

The educational activity presented above may involve simulated case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient is intended or should be inferred.

The material presented here does not necessarily reflect the views of Medscape, LLC, or companies that support educational programming on medscape.org. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

References

Faculty and Disclosures

Moderator

James L. Januzzi, MD

Panelists

Christian Mueller, MD

W. Frank Peacock, MD

Rick Body, MBChB, PhD

Steering Committee

James L. Januzzi, MD

Javed Butler, MD, MBA, MPH

Robert H. Christenson, PhD

Lori B. Daniels, MD, MAS

Peter S. Pang, MD

Editors

Joy P. Marko, MS, APN-C, CCMEP

Kalanethee Paul-Pletzer, PhD

CME Reviewer/Nurse Planner

Amy Bernard, MS, BSN, RN-BC

Peer Reviewer

CME / ABIM MOC / CE

Part III Lessons Learned: A Master Class in High-Sensitivity Troponin: A Global Perspective

Target Audience and Goal Statement

Disclosures

Moderator

James L. Januzzi, MD

Panelists

Christian Mueller, MD

W. Frank Peacock, MD

Rick Body, MBChB, PhD

Steering Committee

James L. Januzzi, MD

Javed Butler, MD, MBA, MPH

Robert H. Christenson, PhD

Lori B. Daniels, MD, MAS

Peter S. Pang, MD

Editors

Joy P. Marko, MS, APN-C, CCMEP

Kalanethee Paul-Pletzer, PhD

CME Reviewer/Nurse Planner

Amy Bernard, MS, BSN, RN-BC

Peer Reviewer

Accreditation Statements

For Physicians

For Nurses

Instructions for Participation and Credit

Part III Lessons Learned: A Master Class in High-Sensitivity Troponin: A Global Perspective