READERS’ COMMENTS How to Avoid Inappropriate Interpretation and Reporting of Troponin Results Measured With High-Sensitivity Assays in the Emergency Department After reading the report by Pfortmueller et al,1 we are concerned that readers might be negatively influenced by the unsupported and wrong conclusions on the diagnostic performance of highsensitivity troponin T (hsTnT) in patients with suspected acute coronary syndrome, particularly in those with renal insufficiency. The analyses are based on a cross-sectional survey on 1,514 consecutive patients admitted to the emergency department of the University Department of Bern. An elevated cardiac troponin T value greater than the ninetyninth percentile of a healthy reference population was found in 346 consecutive patients (22.8%) admitted with suspected acute coronary syndrome, of whom 170 patients (49%) were diagnosed as having an acute myocardial infarction (AMI). In another 176 patients (51%), elevated cardiac troponin T values were related to noncardiac causes. The most important finding of this survey was that a single hsTnT on presentation performed only moderately (area under the curve 0.741) for the diagnosis of an AMI in patients with preserved renal function (Modification of Diet in Renal Disease [MDRD]estimated glomerular filtration rate [eGFR] >60 ml/min) and poorly (area under the curve 0.531) in patients with a moderately or severely reduced renal function (MDRD-eGFR