Twerenbold et al reviewed the 0/1-hour algorithm of the European Society of Cardiology for early diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI). The authors are from multiple institutions in Europe.
Patient selection: possible non-STEMI AMI
Analysis:
(1) serum troponin T, high sensitivity, Elecys (Roche)
(2) serum troponin I, high sensitivity, STAT (Abbott Laboratories)
Parameters:
(1) serum troponin T in ng/L at presentation (time 0)
(2) serum troponin T in ng/L 1 hour later
interval change in serum troponin =
= (serum troponin at 1 hour) - (serum troponin at time 0)
Troponin Time 0
Interval Change
Group
NSTEMI
< 5
NA
rule-out
0%
< 12
< 3
rule-out
0.3%
< 12
3 or 4
observe
subset of 14.3%
12 to 51
< 5
observe
subset of 14.3%
NA
>= 5
rule-in
66%
>= 52
NA
rule-in
79%
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