Evidence map›Paper›PMID 29101287›Full record

ArticleCirculation2018

0/1-Hour Triage Algorithm for Myocardial Infarction in Patients With Renal Dysfunction.

Raphael Twerenbold, Patrick Badertscher, Jasper Boeddinghaus, Thomas Nestelberger, Karin Wildi, Christian Puelacher, Zaid Sabti, Maria Rubini Gimenez, Sandra Tschirky, Jeanne du Fay de Lavallaz and 18 more

Registry-linked trialOpen access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00470587 (Advantageous Predictors of Acute Coronary Syndromes Evaluation), which is not on this map. Cited by 78 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 3 pooled it
8.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00470587 completednot on this map

Advantageous Predictors of Acute Coronary Syndromes Evaluation (APACE) Study

TypeobservationalSponsorUniversity Hospital, Basel, SwitzerlandRan2006 to 2025Enrolled10,000ConditionsMyocardial Infarction, Angina, Unstable
3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 3 syntheses or guidelines pooled it, 166 citations in OpenAlex.

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  17. Impact of impaired renal function on kinetics of high-sensitive cardiac troponin following cardiac surgery.Clinical research in cardiology : official journal of the German Cardiac Society · 2025
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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

28 authors at 8 institutions in 5 countries.

Raphael TwerenboldCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Patrick BadertscherCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Jasper BoeddinghausCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Thomas NestelbergerCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Karin WildiCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Christian PuelacherCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Zaid SabtiCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Maria Rubini GimenezCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Sandra TschirkyCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Jeanne du Fay de LavallazCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Nikola KozhuharovCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Lorraine SazgaryCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Deborah MuellerCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Tobias BreidthardtCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Ivo StrebelCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Dayana Flores WidmerCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Samyut ShresthaCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Òscar MiróEmergency Department, Hospital Clinic, Barcelona, Spain (O.M.).
F Javier Martín-SánchezEmergency Department, Hospital Clinico San Carlos, Madrid, Spain (F.J.M.S.).
Beata Morawiec2nd Cardiology Department, Zabrze, University Silesia, Katowice, Poland (B.M.).
Jiri ParenicaDepartment of Cardiology, University Hospital Brno, Czech Republic (J.P.).
Nicolas GeigyEmergency Department, Kantonsspital Liestal, Switzerland (N.G.).
Dagmar I KellerEmergency Department, University Hospital Zürich, Switzerland (D.I.K.).
Katharina RentschDepartment of Laboratory Medicine, University Hospital Basel, Switzerland (K.R.).
Arnold von EckardsteinDepartment of Laboratory Medicine, University Hospital Zürich, Switzerland (A.v.E.).
Stefan OsswaldCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Tobias ReichlinCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.).
Christian MuellerCardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, University of Basel, Switzerland (R.T., P.B., J.B., T.N., K.W., C.P., Z.S., M.R.G., S.T., J.d.F.d.L., N.K., L.S., D.M., T.B., I.S., D.F.W., S.S., S.O., T.R., C.M.) christian.mueller@usb.ch.
University of Basel · CHUniversity Hospital of Basel · CHUniversity Hospital of Zurich · CHHospital Clínic de Barcelona · ESHospital Clínico San Carlos · ESKantonsspital Baselland · CHMasaryk University · CZUniversity of Silesia in Katowice · PL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe European Society of Cardiology recommends a 0/1-hour algorithm for rapid rule-out and rule-in of non-ST-segment elevation myocardial infarction using high-sensitivity cardiac troponin (hs-cTn) concentrations irrespective of renal function. Because patients with renal dysfunction (RD) frequently present with increased hs-cTn concentrations even in the absence of non-ST-segment elevation myocardial infarction, concern has been raised regarding the performance of the 0/1-hour algorithm in RD.

methodsIn a prospective multicenter diagnostic study enrolling unselected patients presenting with suspected non-ST-segment elevation myocardial infarction to the emergency department, we assessed the diagnostic performance of the European Society of Cardiology 0/1-hour algorithm using hs-cTnT and hs-cTnI in patients with RD, defined as an estimated glomerular filtration rate <60 mL/min/1.73 m

resultsAmong 3254 patients, RD was present in 487 patients (15%). The prevalence of non-ST-segment elevation myocardial infarction was substantially higher in patients with RD compared with patients with normal renal function (31% versus 13%,

conclusionsIn patients with RD, the safety of the European Society of Cardiology 0/1-hour algorithm is high, but specificity of rule-in and overall efficacy are decreased. Modifications of the rule-in and rule-out thresholds did not improve the safety or overall efficacy of the 0/1-hour algorithm. CLINICAL

trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT00470587.

Indexed as

AlgorithmsDecision Support TechniquesGlomerular Filtration RateTriageAgedAged, 80 and overBiomarkersCreatinineEuropeFemaleHumansKidneyKidney DiseasesMaleMiddle AgedNon-ST Elevated Myocardial InfarctionBiomarkersCreatinineTroponin0/1-hour algorithmchronic kidney diseasediagnosis of acute myocardial infarctionhigh-sensitivity cardiac troponinrenal dysfunction

Identifiers

PMID29101287
PMCPMC5794234
OpenAlexW2766202507

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.