Dangerous Statements

The Interdisciplinary Management of Acute Chest Pain by Dr. med. Raphael R. Bruno, Prof. Dr. med. Norbert Donner-Banzhoff, Prof. Dr. med. Wolfgang Söllner, Prof. Dr. med. Thomas Frieling, Prof. Dr. med. Christian Müller, and Prof. Dr. med. Michael Christ in issue 45/2015

In the CME article „The Interdisciplinary Management of Acute Chest Pain,“ the rule-in and rule-out criteria are presented within a proposed 1-hour algorithm (1). Dissemination of such criteria for the hs-cTnI assay (Dimension Vista, Siemens Healthcare) is highly dangerous, as there is no such assay on the market—the only available assay is several-fold less sensitive. While these criteria have been recently included in the European Guidelines, they have only been used with an assay intended for research that has never reached market maturity.

These statements are therefore dangerous, as physicians who work in hospitals, and whose laboratories are equipped with the Dimension Vista analysis system, may wrongly assume that the troponin I assay can be applied to the criteria. Within the daily routine, it can happen that not enough attention is paid to the units of the laboratory values ​​(given here as ng/L), which could lead to fatal misjudgements. I have published a letter concerning this in „Clinical Chemistry and Laboratory Medicine“ (2).

I would kindly request that you correct this, as presenting this incorrect figure could have serious consequences for patients

DOI: 10.3238/arztebl.2016.0362b

PD Dr. med. Berndt Zur
Universitätsklinikum Bonn

Conflict of interest statement

The author declares that no conflict of interest exists.

References

1. Bruno RR, Donner-Banzhoff N, Söllner W, Frieling T, Müller C, Christ M: The interdisciplinary management of acute chest pain. Dtsch Arztebl Int 2015; 112: 768–80

2. Zur B, Stoffel-Wagner B: Misleading high-sensitivity troponin algorithm for NSTEMI in the ESC guidelines. Clin Chem Lab Med 2015; 53: e323