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Ronny Alcalai, MD; David Planer, MD; Arthur Pollak, MD; Chaim Lotan, MD

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We thank Latif for his knowledgeable comments. The term NTTE was used by us¹ and previously by Jeremias et al² to describe a clinical state in which the cause for troponin elevation is not an acute thrombotic event in the coronary arteries. Though the term NTTE implies the absence of thrombus in the coronary circulation, still, it is a clinical diagnosis based on several factors of which coronary angiography is only one. Similarly in the case of acute coronary syndrome, which implies the presence of thrombus in the coronary circulation, the diagnosis is based on the whole clinical presentation rather than the coronary angiogram.³ Furthermore, the absence of coronary thrombus or obvious rupture plaque cannot rule out the diagnosis of acute coronary syndrome (ACS) if the clinical presentation is highly suggestive; hence, it cannot rule in . . . [Full Text of this Article]

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RELATED LETTER

Nonspecific Troponin Elevation
Faisal Latif
Arch Intern Med. 2007;167(17):1906-1907.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Acute Coronary Syndrome vs Nonspecific Troponin Elevation: Clinical Predictors and Survival Analysis
Ronny Alcalai, David Planer, Afsin Culhaoglu, Aydin Osman, Arthur Pollak, and Chaim Lotan
Arch Intern Med. 2007;167(3):276-281.
ABSTRACT | FULL TEXT