0/2 h-Algorithm for Rapid Triage of Suspected Myocardial Infarction Using a Novel High-Sensitivity Cardiac Troponin I Assay

Background We aimed to derive and validate a 0/2 h-algorithm using the new high-sensitivity cardiac troponin I (hs-cTnI)-VITROS assay (VITROS® Immunodiagnostic Products hs-Troponin I Reagent Pack, Ortho Clinical Diagnostics) for rapid rule-out/in of non-ST-segment elevation myocardial infarction (NS...

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Published in:Clinical chemistry (Baltimore, Md.) Md.), 2022-02, Vol.68 (2), p.303-312
Main Authors: Wildi, Karin, Boeddinghaus, Jasper, Nestelberger, Thomas, Lopez-Ayala, Pedro, Yufera Sanchez, Ana, Okamura, Bernhard, Shrestha, Samyut, Rohner, Jennifer, Miró, Òscar, Martinez-Nadal, Gemma, Martin-Sanchez, F Javier, Koechlin, Luca, Twerenbold, Raphael, Christ, Michael, Kawecki, Damian, Rubini Giménez, Maria, Keller, Dagmar I, Mueller, Christian, Wussler, Desiree, Strebel, Ivo, Bakula, Adam, Frey, Simon, Gualandro, Danielle M, Zimmermann, Tobias, Puelacher, Christian, du Fay de Lavallaz, Jeanne, Potlukova, Eliska, Diebold, Matthias, Geigy, Nicolas, Rentsch, Katharina, Mitrovic, Sandra, Fuenzalida, Carolina, Glarner, Noemi, Morawiec, Beata, Breidthardt, Tobias, Freese, Michael, López, Beatriz, Calderón, Sofia, Adrada, Esther Rodriguez, Ganovská, Eva, Parenica, Jiri, von Eckardstein, Arnold, Campodarve, Isabel, Gea, Joaquim
Format: Article
Language:English
Subjects:
Algorithms
Assaying
Calcium-binding protein
Chest
Confidence intervals
Derivation
Diagnosis
Emergency medical care
Emergency medical services
Heart
Heart attack
Heart attacks
Mathematical models
Medical diagnosis
Myocardial infarction
Pain
Patients
Physiological aspects
Reagents
Sensitivity
Thresholds
Troponin
Troponin I
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Summary:Background We aimed to derive and validate a 0/2 h-algorithm using the new high-sensitivity cardiac troponin I (hs-cTnI)-VITROS assay (VITROS® Immunodiagnostic Products hs-Troponin I Reagent Pack, Ortho Clinical Diagnostics) for rapid rule-out/in of non-ST-segment elevation myocardial infarction (NSTEMI). Methods The final diagnosis was centrally adjudicated by 2 independent cardiologists according to the fourth universal definition of myocardial infarction (MI) among 1888 patients presenting to the emergency department with acute chest pain. hs-cTnI-VITROS concentrations were measured at presentation and at 2 h in a blinded fashion. The optimal assay-specific thresholds for the hs-cTnI-VITROS 0/2 h-algorithm were derived in a randomly selected 70% of the cohort and validated in the remaining 30%. Results NSTEMI was the final diagnosis in 216/1322 (16.3%) patients of the derivation cohort. Rule-out was defined as baseline hs-cTnI concentrations of 3 h or a baseline hs-cTnI concentration of
ISSN:0009-9147
1530-8561
DOI:10.1093/clinchem/hvab203