1. A troponin value above the 99th percentile of the upper
reference level is required. Additionally, evidence for a
serial increase or decrease ≥20% is required if the initial
value is elevated.21,178
2. For any troponin values below or close to the 99th
percentile, evidence for acute myocardial necrosis is
indicated by a change of ≥3 standard deviations of the
variation around the initial value as determined by the
individual laboratory.21,179
3. Clinical laboratory reports should indicate whether significant
changes in cardiac troponin values for the particular
assay have occurred.