Performance of the European Society of Cardiology 0/1-Hour Algorithm With High-Sensitivity Cardiac Troponin T Among Patients With Known Coronary Artery Disease
Authors' conclusion
Among patients with known CAD, the ESC 0/1-hour hs-cTnT algorithm was unable to safely exclude 30-day cardiac death or MI.
Study context
- Population
- ED patients ≥21 years with symptoms suggestive of ACS without ST-segment elevation on initial ECG, 8 US EDs, 2017–2018
- Participants
- 1,430 patients
- Comparison
- European Society of Cardiology (ESC) 0/1-hour high-sensitivity cardiac troponin T (hs-cTnT) algorithm performance in patients with vs without known coronary artery disease (CAD)
- Known CADn = 449
- Without CADn = 981reference
- Primary endpoint
- Cardiac death or MI determined by expert adjudicators
- Follow-up
- 30 days
Methodological detailsmulticentre, 8 US EDs, diagnostic accuracy
- Multicentre
- 8 US EDs
- Diagnostic accuracy
Primary result
As reported in the abstract
30-day cardiac death or MI in rule-out zone; NPV
| Group | Value | Ruled out | NPV |
|---|---|---|---|
| Known CAD | 3.4% | 178 of 449 (39.6%) | 96.6% (95% CI, 92.8-98.8) |
| Without CAD | 1.1% | 648 of 981 (66.1%) | 98.9% (95% CI, 97.8-99.6) |
Value
Known CAD3.4%
Without CAD1.1%
Ruled out
Known CAD178 of 449 (39.6%)
Without CAD648 of 981 (66.1%)
NPV
Known CAD96.6% (95% CI, 92.8-98.8)
Without CAD98.9% (95% CI, 97.8-99.6)
- Known CAD vs Without CAD: P < 0.001 — proportion ruled out
- Known CAD vs Without CAD: P < 0.001 — 30-day cardiac death or MI in rule-out zone
- Known CAD vs Without CAD: P = 0.04 — NPV
Further findings
30-day cardiac death or MI, whole cohort
- Cardiac death or MI
- 183 participants (12.8%)
Original publication
Performance of the European Society of Cardiology 0/1-Hour Algorithm With High-Sensitivity Cardiac Troponin T Among Patients With Known Coronary Artery Disease. JAMA Cardiol. Published 1 April 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →