Validation of the European Society of Cardiology 0/1-hour algorithm for chest pain triage in Asian emergency departments: a multinational stepped-wedge cluster-randomised trial
Authors' conclusion
The ESC 0/1-hour algorithm is safe and effective for rapid triage of chest pain in Asian EDs. These findings provide external validation of the 0/1-hour algorithm and support broader global implementation.
Study context
- Population
- Patients with suspected acute coronary syndrome without ST elevation (NSTE-ACS) presenting to Asian emergency departmentspatients enrolled · usual care 2,059 · 0/1-hour care 1,810
- Participants
- 3,869 patients
- Comparison
- European Society of Cardiology (ESC) 0/1-hour algorithm vs usual care for chest pain triage
- Usual caren = 2,059
- 0/1-hour caren = 1,810
- Primary endpoint
- Major adverse cardiac events (MACE), including cardiovascular death, myocardial infarction (MI) and unplanned revascularisation
- Follow-up
- 30-day
Methodological details12 hospitals in five Asian countries, multinational
- 12 hospitals in five Asian countries
- Multinational
Primary result
As reported in the abstract
- Upper one-sided 95% CI
- −0.3%
Further findings
ED discharge rates · significantly higher with the 0/1-hour algorithm
P < 0.001
Major adverse cardiac events (MACE) among patients classified as low risk group
- Low risk group patients
- 941
- MACE, of the 941 low-risk patients
- 3 patients
- Cardiovascular death, of the 941 low-risk patients
- one
- Unplanned revascularisations, of the 941 low-risk patients
- two
- No non-fatal myocardial infarction (MIs) were reported
Original publication
Validation of the European Society of Cardiology 0/1-hour algorithm for chest pain triage in Asian emergency departments: a multinational stepped-wedge cluster-randomised trial. Heart. Published 23 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it