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Vessel Plus 2022;6:[Accepted].10.20517/2574-1209.2022.34© The Author(s) 2023
Accepted Manuscript
Open AccessOriginal Article

Efficacy and safety of a 0/1-h high-sensitivity cardiac troponin I (hs-cTnI) protocol to rule out acute coronary syndrome over a one-year period 

Correspondence Address: Dr. Brandon Allen, Department of Emergency Medicine, University of Florida College of Medicine, 1329 SW 16th Street, PO Box 100186, Gainesville, FL 32610-0186, USA. E-mail: brandonrallen@ufl.edu


© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.


Aim: Evaluate the diagnostic and prognostic performance of the ESC 0/1H Algorithm and its utility in safely discharging patients with suspected Acute Coronary Syndrome (ACS) in the Emergency Department.  

Methods: This analysis is a retrospective cohort study of 3,156 patients presenting to an academic medical center emergency department (ED) between May 20, 2019 and May 31, 2020. Patients determined to have symptoms concerning for ACS who completed the Beckman Coulter Access High Sensitivity Troponin I (hs-TnI) assay per current institution protocol (T0, T1H, T3H) were retrospectively analyzed using the ESC 0/1H Algorithm to assess the safety and efficacy of a rule-out algorithm for early discharge. 

Results: The negative predictive value (NPV) of the protocol (T0 < 6 pg/mL; or females with T0 ≤15 pg/mL and T1 ≤ 15pg/mL; or males with T0 ≤ 20 pg/mL and T1 ≤ 20 pg/mL) was 99.4% (95%C: 99.0-99.7%) for acute myocardial injury (AMI) at index and/or 30 day cardiac-related death. The negative likelihood ratio was 0.08 (95%CI: 0.05-0.13), and the specificity was 86.3% (95%CI: 85.0-87.5%).

Conclusion: The protocol was found to have a NPV greater than 99% and negative likelihood ratio of 0.08, suggesting it is safe to use for patients presenting to the ED with ACS symptoms no matter the time of symptom onset.

Cite This Article

Perryman K, Winchester D, Massoomi M, Warren E, Morris L, Beal S, Radhakrishnan N, Ghaffar U, Sammon J, Raman J, Lewis M, Crabb D, Holtzman L, Allen B. Efficacy and safety of a 0/1-h high-sensitivity cardiac troponin I (hs-cTnI) protocol to rule out acute coronary syndrome over a one-year period. Vessel Plus 2022;6:[Accept]. http://dx.doi.org/10.20517/2574-1209.2022.34

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