Rapid identification of acute myocardial infarction (MI) is important for the early initiation of evidence-based therapy. In the European Society of Cardiology (ESC) 0/1h-algorithm (also called early-rule-out algorithm) high-sentivity cardiac troponin is measured at admission and one hour later. By using assay-specific cut-off levels patients are triaged to three different groups; "rule-out", "observation" or "rule-in" of acute MI. The ESC 0/1h-algorithm has high diagnostic accuracy and safety to rule out MI. This review summaries the current knowledge and practical use of the new early-rule-out algorithm.
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External validation of the myocardial-ischaemic-injury-index machine learning algorithm for the early diagnosis of myocardial infarction: a multicentre cohort study.
Lancet Digit Health
July 2024
Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; GREAT Association, Rome, Italy. Electronic address:
Background: The myocardial-ischaemic-injury-index (MI) is a novel machine learning algorithm for the early diagnosis of type 1 non-ST-segment elevation myocardial infarction (NSTEMI). The performance of MI, both when using early serial blood draws (eg, at 1 h or 2 h) and in direct comparison with guideline-recommended algorithms, remains unknown. Our aim was to externally validate MI and compare its performance with that of the European Society of Cardiology (ESC) 0/1h-algorithm.
View Article and Find Full Text PDFAssociation of accompanying dyspnoea with diagnosis and outcome of patients presenting with acute chest discomfort.
Eur Heart J Acute Cardiovasc Care
May 2023
Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Aims: The presence of accompanying dyspnoea is routinely assessed and common in patients presenting with acute chest pain/discomfort to the emergency department (ED). We aimed to assess the association of accompanying dyspnoea with differential diagnoses, diagnostic work-up, and outcome.
Methods And Results: We enrolled patients presenting to the ED with chest pain/discomfort.
Extending the no objective testing rules to patients triaged by the European Society of Cardiology 0/1-hour algorithms.
Eur Heart J Acute Cardiovasc Care
November 2022
Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Aims: After rule-out of non-ST elevation myocardial infarction (NSTEMI) with the European Society of Cardiology (ESC) 0/1 h-algorithms, it is unclear which patients require further anatomical or functional cardiac testing. To test the safety and efficacy of the no-objective-testing (NOT)-rules after NSTEMI rule-out by the ESC 0/1 h-algorithms.
Methods And Results: International, prospective, diagnostic multicentre study enrolling adult patients presenting with chest pain to the emergency department.
Lower diagnostic accuracy of hs-cTnI in patients with prior coronary artery bypass grafting.
Int J Cardiol
May 2022
Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland; GREAT network, University Hospital Basel, University of Basel, Switzerland. Electronic address:
Background: High-sensitivity cardiac troponin T (hs-cTnT) and the ESC 0/1h-hs-cTnT-algorithm have worse performance in the early diagnosis of myocardial infarction (MI) in patients with prior coronary artery bypass grafting (CABG). It is unknown, whether this concern applies also to hs-cTnI, the most widely used analyte worldwide.
Methods: In an international multicenter diagnostic study, two cardiologists centrally adjudicated the final diagnosis in patients presenting to the emergency department with symptoms suggestive of MI according to the Third Universal Definition of MI.
A 0/1h-algorithm using cardiac myosin-binding protein C for early diagnosis of myocardial infarction.
Eur Heart J Acute Cardiovasc Care
June 2022
Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Aims: Cardiac myosin-binding protein C (cMyC) demonstrated high diagnostic accuracy for the early detection of non-ST-elevation myocardial infarction (NSTEMI). Its dynamic release kinetics may enable a 0/1h-decision algorithm that is even more effective than the ESC hs-cTnT/I 0/1 h rule-in/rule-out algorithm.
Methods And Results: In a prospective international diagnostic study enrolling patients presenting with suspected NSTEMI to the emergency department, cMyC was measured at presentation and after 1 h in a blinded fashion.
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