TNNT2 and myocardial infarction: However, follow-up at 1 year demonstrated an increase in both subsequent myocardial infarction and death in patients with low troponin concentrations identified by the hs-cTnT assay and randomised to the 1-hour strategy compared with the 3-hour pathway using the 99th centile.28 The explanation for these unexpected findings is not clear, but they highlight the importance of conducting adequately powered studies that evaluate both the effectiveness and safety of implementing early rule-out pathways.