A rapid 0/1 h algorithm for suspected non-ST-segment elevation myocardial infarction using high-sensitivity cardiac troponin I

We aimed to derive a new high-sensitivity cardiac troponin I Access (hs-cTnI-Access) 0/1h-algorithm suitable for Chinese patients. In the multi-centre study, we enrolled 369 patients with suspected non-ST-segment elevation myocardial infarction (NSTEMI). Following an adjustment, AnZhen hs-cTnI-Access 0/1h-algorithm was established with rule-in cut-off values of 0 h ≥ 50 pg/mL or Δ1h ≥ 18.0 pg/mL and rule-out cut-off values of 0 h < 3 pg/mL or 0 h < 4 pg/mL and Δ1h < 3.0 pg/mL. These revised cutoffs presented a negative predictive value (NPV) of 99.46% (95% CI,97.02-99.91%) and a sensitivity of 98.81% (95% CI,93.56-99.79%), and also resulted in a positive predictive value (PPV) of 86.42% (95% CI,77.30-92.24%) and a specificity of 96.14% (95% CI,93.22-97.83%), both of which were superior to those of the ESC 0/1 h algorithm. The new hs-cTnI-Access 0/1 h-algorithm adjusted for Chinese data is promising for improving both safety and efficacy in Chinese patients.