Summary
Use and utility of the 0/1-Hour and 0/2-Hour High-Sensitivity Cardiac Troponin I algorithms in the diagnosis of Acute Myocardial Infarction in the Emergency Department
Affiliation of the authors
DOI
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De la Fuente García F, Martínez Rua E, Esteve Poblador S. Use and utility of the 0/1-Hour and 0/2-Hour High-Sensitivity Cardiac Troponin I algorithms in the diagnosis of Acute Myocardial Infarction in the Emergency Department. Rev Esp Urg Emerg. 2026;5:99–104
Summary
OBJECTIVE. The 2023 European Society of Cardiology clinical practice guidelines recommend the use of rapid cardiac troponin algorithms to improve the early diagnosis of non–ST-segment elevation acute coronary syndrome (NSTEACS) in emergency departments (EDs). The aim of this retrospective study was to assess the degree of implementation of validated rapid rule-out/rulein algorithms for our automated system in patients with suspected acute myocardial infarction (AMI) presenting to the ED of our hospital.
MATERIALS AND METHODS. We reviewed a total of 200 patients for whom cardiac troponin testing was requested in the ED. Adherence to the rapid algorithms was evaluated, as well as their impact on patient classification regarding the occurrence of acute coronary syndrome (ACS), other cardiac conditions, or alternative diagnoses.
RESULTS. Of the 200 patients, 23 (11,5 %) had troponin levels > 120 ng/L and were classified in the “rule-in” group; 20 patients had values < 3 ng/L (10 %) and were classified as “rule-out”; and 157 (78,5 %) patients had troponin values between 3 and 120 ng/L and were assigned to the “observation” group. Only 12 of these 157 patients underwent repeat troponin testing (7,64 %). Two of them developed NSTEACS after discharge from the ED. Overall, 10 (5 %) of the 200 patients included in the study were ultimately diagnosed with AMI.
CONCLUSIONS. The widespread application of rapid troponin algorithms could improve the diagnosis of NSTEACS.