A new 0 and 2 hour risk assessment for acute myocardial infarction in emergency department patients using a high sensitivity point of care troponin assay
Authors' conclusion
A 0/2 h protocol using the Abbott i-STAT® hs-TnI assay safely risk stratified emergency patients with suspected ACS and had comparable performance to two central laboratory-based assays. The use of POC testing supports timely results and may improve the time to clinical decision-making.
Study context
- Population
- Patients presenting to emergency department (EDs) with symptoms suggestive of acute myocardial infarction (AMI)patients enrolled
- Participants
- 1,021 patients
- Comparison
- POC hs-cTnI measurements compared with central laboratory assay results
- Outcome
- AMI (type 1 and 2) or cardiac death during the index presentation
- Follow-up
- Index presentation
Performance
As reported in the abstract
| Test or model | Sensitivity (low-risk) | NPV (low-risk) | Specificity (high-risk) | PPV (high-risk) |
|---|---|---|---|---|
| 0/2 h strategy using the POC hs-cTnI assay | 98.8% (95% CI: 93.2-100%) | 99.9% (95% CI: 99.2-100%) | 97.7% (95% CI: 96.5-98.5) | 74.7% (95% CI: 64.3-83.4%) |
0/2 h strategy using the POC hs-cTnI assay
Sensitivity (low-risk)98.8% (95% CI: 93.2-100%)
NPV (low-risk)99.9% (95% CI: 99.2-100%)
Specificity (high-risk)97.7% (95% CI: 96.5-98.5)
PPV (high-risk)74.7% (95% CI: 64.3-83.4%)
Further findings
AMI diagnosis
- AMI diagnosed
- 80 patients (7.8%)
Patients identified as low-risk · within 2 h
- Identified as low-risk
- 66.7%
Safety
30 day major adverse cardiac events (MACE) (incorporating AMI and cardiac death) among low-risk patients (primary safety endpoint) · 30 day follow-up
- Low risk patients having a MACE diagnosis
- 6 low risk patients (0.9%)
Original publication
A new 0 and 2 hour risk assessment for acute myocardial infarction in emergency department patients using a high sensitivity point of care troponin assay. Eur Heart J Acute Cardiovasc Care. Published 11 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it