Using a simple algorithm incorporating hs-cTnT baseline values and absolute changes within the first hour allowed a safe rule-out as well as an accurate rule-in of AMI within 1 hour in 77% of unselected patients with acute chest pain. This novel strategy may obviate the need for prolonged monitoring and serial blood sampling in 3 of 4 patients.

No abstract

An early-discharge strategy using an hs-TnI assay and TIMI score ≤ 1 had similar safety as previously reported, with the potential to decrease the observation periods and admissions for approximately 40% of patients with suspected ACS. (Advantageous Predictors of Acute Coronary Syndromes Evaluation [APACE] Study, NCT00470587; A 2 hr Accelerated Diagnostic Protocol to Assess patients with chest Pain symptoms using contemporary Troponins as the only biomarker [ADAPT]: a prospective observational validation study, ACTRN12611001069943).

Supplemental Digital Content is available in the text.

Interpretation: This rapid strategy incorporat ing highsensitivity cardiac troponin T baseline values and absolute changes within the first hour substantially accelerated the manage ment of suspected acute MI by allowing safe ruleout as well as accurate rulein of acute MI in 3 out of 4 patients. Trial registration: Clinical Trials.gov, NCT00470587 AbstractResearch