Improving risk stratification for hospital mortality using troponin: is it time for a change of heart?

In a recent issue of the journal Critical Care, Docherty et al. described their analysis of a strategy of routine cardiac troponin I (cTnI) testing at the Glasgow Royal Infirmary (1). In their study, they analyzed an observational cohort over 4 years at two busy ICUs, with independent derivation and validation cohorts, to determine whether cTnI testing added value to routine clinical evaluation of critically ill patients. What they found should cause some discomfort to all clinicians who take care of critically ill patients.