The detection of increased serum levels of cardiac troponins in a clinical context of acute myocardial ischemia is a crucial finding for the diagnosis of acute myocardial infarction (AMI) [1,2]. However, troponins may increase in various conditions of myocardial injury different from ischemic myocardial necrosis (e.g. anemia, hypoxemia, renal failure, heart failure, sepsis, tachyarrhythmias, etc.) [3,4]. Furthermore, a few studies suggested that cardiac troponins might also increase simply following myocardial ischemia, in the absence of cell necrosis [5–11], also suggesting the possibility that a significant increase of troponins after stress testing might increase the diagnostic yield for obstructive coronary artery disease (CAD).
