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In ED patient samples (n=718), the incidence of elevated cTnI above the sex-specific 99th percentile URL was not significantly different between the hs-cTnI and contemporary cTnI assays in either sex (male hs-cTnI 16.6% vs. cTnI 21.5%, p=0.13; female hs-cTnI 19.6% vs. cTnI 21.1%, p=0.66). The agreement between the two assays was 93.5% (kappa=0.798). Results were confirmed in an independent patient cohort measured by the same instruments at another hospital. Our study suggests that implementation of the hs-cTnI assay would not lead to an