Lee KK, Ferry AV, Anand A, et al. - Researchers examined how the implementation of a high-sensitivity cardiac troponin I assay with gender-specific diagnostic thresholds for myocardial infarction influences women and men with suspected acute coronary syndrome. In a stepped-wedge, cluster-randomized controlled trial, they enrolled 48,282 patients (47% women) with suspected acute coronary syndrome across 10 hospitals. High-sensitivity cardiac troponin I concentration > 99th centile of 16 ng/l defined myocardial injury in women and high-sensitivity cardiac troponin I concentration > 99th centile of 34 ng/l defined myocardial injury in men. The use of gender-specific thresholds led to identification of 5 times more additional women than men with myocardial injury. However, women underwent nearly one-half the number of treatments for coronary artery disease as men, and there was no improvement in outcomes.