Zero-hour thresholds to risk stratify patients for acute myocardial infarction using a point-of-care high-sensitivity troponin assay
Authors' conclusion
This study identified two hs-cTnI thresholds (<5 ng/L or <8 ng/L) to identify patients at low risk and two thresholds (>25 ng/L and >60 ng/L) to identify patients at high risk for MI. Our findings provide promise for improving care in rural and inner-city medical settings.
Study context
- Population
- Patients with suspected acute coronary syndrome who had blood drawn on presentation to the emergency department for hs-cTnI measurementpatients with blood drawn on presentation for hs-cTnI measurement
- Participants
- Nine hundred sixty-seven patients
- Exposure
- Single presentation point of care hs-cTnI value against index myocardial infarction (MI), with diagnostic accuracy at a range of hs-cTnI values
- Outcome
- Index MI including type one or two non-ST segment elevation MI
- Follow-up
- Presentation
Main finding
As reported in the abstract
- Patients meeting the criteria for MI
- 5.6%
- Highest threshold to achieve an NPV >99.5%
- <8 ng/L
- Sensitivity at <8 ng/L
- 94.4% (95% CI: 84.6-98.8%)
- Sensitivity at <5 ng/L
- 100% (95% CI: 93.4-100.0%)
- Highest PPV, at >60 ng/L
- 68.3%, 95% CI: 51.9-81.9%
- PPV at >25 ng/L
- 50% (95% CI: 38.0-62.0%)
Observational data: associations, not effects.
Original publication
Zero-hour thresholds to risk stratify patients for acute myocardial infarction using a point-of-care high-sensitivity troponin assay. Eur Heart J Acute Cardiovasc Care. Published 2 May 2025. doi:10.
Summarised from the published abstract; every number is checked against it