Performance of the ESC 0/2h-algorithm using high-sensitivity cardiac troponin I in the early diagnosis of myocardial infarction

Luca Koechlin; Jasper Boeddinghaus; Thomas Nestelberger; Pedro Lopez-Ayala; Desiree Wussler; Samyut Shrestha; Tobias Resa; Karin Wildi; Adam Bakula; Simon Frey; Òscar Miró; F Javier Martin-Sanchez; Ivo Strebel; Danielle M Gualandro; Friedrich S Eckstein; Oliver Reuthebuch; Dagmar I Keller; Raphael Twerenbold; Maria Rubini Giménez; Christian Mueller; APACE investigators

doi:10.1016/j.ahj.2021.08.008

Performance of the ESC 0/2h-algorithm using high-sensitivity cardiac troponin I in the early diagnosis of myocardial infarction

Am Heart J. 2021 Dec:242:132-137. doi: 10.1016/j.ahj.2021.08.008. Epub 2021 Sep 9.

Authors

Luca Koechlin¹, Jasper Boeddinghaus², Thomas Nestelberger³, Pedro Lopez-Ayala², Desiree Wussler⁴, Samyut Shrestha⁴, Tobias Resa², Karin Wildi⁵, Adam Bakula⁶, Simon Frey⁶, Òscar Miró⁷, F Javier Martin-Sanchez⁸, Ivo Strebel², Danielle M Gualandro², Friedrich S Eckstein⁹, Oliver Reuthebuch⁹, Dagmar I Keller¹⁰, Raphael Twerenbold², Maria Rubini Giménez¹¹, Christian Mueller¹²; APACE investigators

Collaborators

APACE investigators:
Tobias Zimmermann¹³, Tobias Reichlin¹⁴, Michael Christ¹⁵, Christian Puelacher¹⁶, Jeanne du Fay de Lavallaz¹³, Eliska Potlukova¹⁶, Matthias Diebold¹⁶, Damian Kawecki¹⁷, Nicolas Geigy¹⁸, Katharina Rentsch¹⁹, Sandra Mitrovic¹⁹, Carolina Fuenzalida²⁰, Noemi Glarner²¹, Beata Morawiec²², Piotr Munzk²², Tobias Breidthardt²¹, Michael Freese¹³, Beatriz López²⁰, Sofia Calderón²⁰, Esther Rodriguez Adrada⁸, Eva Ganovská²³, Jiri Parenica²³, Arnold von Eckardstein²⁴, Isabel Campodarve²⁵, Joaquim Gea²⁵

Affiliations

¹ Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Cardiac Surgery, University Hospital Basel, University of Basel, Basel, Switzerland; GREAT network.
² Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; GREAT network.
³ Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; GREAT network; Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
⁴ Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; GREAT network; Division of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
⁵ Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; GREAT network; Critical Care Research Group, the Prince Charles Hospital, Brisbane, Australia; University of Queensland, Brisbane, Australia.
⁶ Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
⁷ GREAT network; Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain.
⁸ GREAT network; Hospital Clínico San Carlos, Madrid, Spain.
⁹ Department of Cardiac Surgery, University Hospital Basel, University of Basel, Basel, Switzerland.
¹⁰ Emergency Department, University Hospital Zurich, Zurich, Switzerland.
¹¹ Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; GREAT network; Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Germany.
¹² Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; GREAT network. Electronic address: christian.mueller@usb.ch.
¹³ Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland; GREAT network.
¹⁴ Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland; GREAT network; Department of Cardiology, Inselspital, University of Bern, Rome, Italy.
¹⁵ Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland; Emergency Department, Kantonsspital Luzern, Switzerland.
¹⁶ Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland; GREAT network; Department of Internal Medicine, University Hospital Basel, University of Basel, Switzerland.
¹⁷ GREAT network; 2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Katowice, Poland.
¹⁸ Critical Care Research Group, and The University of Queensland, Brisbane, Australia.
¹⁹ Laboratory Medicine, University Hospital Basel, Switzerland.
²⁰ GREAT network; Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain.
²¹ Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland; GREAT network; 2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Katowice, Poland.
²² GREAT network; Critical Care Research Group, and The University of Queensland, Brisbane, Australia.
²³ GREAT network; Department of Cardiology, University Hospital Brno, Brno, Czech Republic and Medical Faculty, Masaryk University, Brno, Czech Republic.
²⁴ Department of Laboratory Medicine, University Hospital Zurich, Zurich, Switzerland.
²⁵ Hospital del Mar - IMIM. UPF. CIBERES. Barcelona, Spain.

PMID: 34508692
DOI: 10.1016/j.ahj.2021.08.008

Abstract

The 2020 guidelines of the European Society of Cardiology (ESC) recommend a novel ESC 0/2h-algorithm as the preferred alternative to the ESC 0/1h-algorithm in the early triage for rule-out and/or rule-in of Non-ST-segment-elevation myocardial infarction (NSTEMI). The aim was to prospectively validate the performance of the ESC 0/2h-algorithm using the high-sensitivity cardiac troponin I (hs-cTnI) assay (ARCHITECT) in an international, multicenter diagnostic study enrolling patients presenting with acute chest discomfort to the emergency department.

Trial registration: ClinicalTrials.gov NCT00470587.

Publication types

Letter
Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Algorithms*
Biomarkers / blood
Early Diagnosis
Humans
Myocardial Infarction* / blood
Myocardial Infarction* / diagnosis
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Troponin I* / blood

Substances

Biomarkers
Troponin I

Associated data

ClinicalTrials.gov/NCT00470587