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Heather Horton, MD, PhD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Shah et al¹ have analyzed troponin-only positive "myocardial infarctions" (MIs) with regard to guideline-based management and report that guideline-based therapies are underused. I am not certain their analysis is correct. When the criteria for MI were revised to include troponin-only positive MIs, I was concerned that we were not looking at a homogeneous population when compared with patients who presented with electrocardiographic changes and elevated creatine phosphokinase of muscle band (CPK-MB) level. When I expressed my concern to a member of the committee who revised the definition, I was told not to worry about it, that it would be better for the hospital because we would get more reimbursement for all these new MIs. Recently, in my own cardiology practice I have seen elevated troponin levels in cases of diabetic ketoacidosis (cardiac catheterization showed normal coronary arteries), urosepsis, acidosis, pneumonia, sepsis, severe chronic obstructive pulmonary disease, . . . [Full Text of this Article]

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