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We studied 70 patients with non–ST-elevation myocardial infarction (NSTEMI). We excluded patients with ST-elevation myocardial infarction, heart failure, and shock at admission in the emergency department. We measured TnI at admission and determined the ejection fraction and the number of myocardial segments affected by echocardiography Doppler before discharge. There was no correlation between TnI and left ventricular function in NSTEMI, but there was a linear correlation with infarct size in NSTEMI (r = 0.67; P b .001). We could conclude that a single measurement of TnI at admission in patients with NSTEMI proved useful for estimation of infarct size but not for estimation of the left ventricular function. Pablo Elissamburu MD Nicolas Lalor MD Leandro Rodriguez MD Diego Conde MD Cardiology Division, Instituto Cardiovascular de Buenos Buenos Aires, Argentina Cardiology Division, Sanatorio Anchorena Buenos Aires, Argentina E-mail address: [email protected]

Fourth-generation troponin I and infarct size in patients without ST-elevation myocardial infarction? To the Editor,

http://dx.doi.org/10.1016/j.ajem.2013.11.023

Troponin I (TnI) and high-sensitive troponin T after acute myocardial infarction have proven useful for estimation of the complex and extension of coronary lesions in acute coronary syndromes, and high-sensitive troponin T has proven useful for estimation of the infarct size in this population too, but the value of TnI for assessment of left ventricular function and infarct size is not well known [1-4]. The aim of the present study was to correlate infarct size and left ventricular function determined by echocardiography Doppler with plasma levels of TnI after acute myocardial infarction.

References [1] Conde D, Elissamburu P, Lalor N, Rodriguez L, Trivi M. Fourth generation troponin I levels and complex coronary lesions in acute coronary syndromes. Am J Emerg Med 2013 [in press]. [2] Conde D, Costabel JP, Pedernera G, Trivi M. Relationship between high-sensitive troponin T levels in patients with acute coronary syndrome with ST elevation and complex coronary lesions. Am J Emerg Med 2013;31(7):1145–6. [3] Conde D, Costabel JP, Campos R, Trivi M. High-sensitive troponin T levels and complex coronary lesions. Am J Emerg Med 2013;31(7):1141. [4] 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;124:136–45.