ArticleEuropean heart journal. Acute cardiovascular care2020
RAPID-CPU: a prospective study on implementation of the ESC 0/1-hour algorithm and safety of discharge after rule-out of myocardial infarction.
Article in European heart journal. Acute cardiovascular care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03111862 (Observational Study on the Safety of Accelerated Rule-out Protocols in Patients Admitted With Chest Pain to a Crowded CPU), which is not on this map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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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.
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.
Observational Study on the Safety of Accelerated Rule-out Protocols in Patients Admitted With Chest Pain to a Crowded CPU
Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 94 citations in OpenAlex.
- High-sensitivity troponin assays for early rule-out of acute myocardial infarction in people with acute chest pain: a systematic review and economic evaluation.Health technology assessment (Winchester, England) · 2021Pooled it
- Trial
- The Evolution of Accelerated Diagnostic Protocols for Suspected Myocardial Infarction.Journal of clinical medicine · 2026Review
- Machine learning for diagnosing non-ST-segment elevation myocardial infarction: a derivation and validation study.EClinicalMedicine · 2026Article
- Alternative Rule-Out Cutoffs for a Novel High-Sensitivity Cardiac Troponin I Assay in Patients With Suspected Myocardial Infarction.Journal of the American Heart Association · 2026Observational
- Sex-specific differences in the prognostic value of ischemic pre-hospital ECGs.Frontiers in cardiovascular medicine · 2026Article
- Performance Evaluation of the 2020 European Society of Cardiology 0-hour/1-hour Algorithm Using High-sensitivity Cardiac Troponin I for Non-ST-segment Elevation Acute Coronary Syndrome and Mortality Assessment Based on 1-year Real-world Data.Annals of laboratory medicine · 2026Article
- Validation of a 0-/2-Hour High-Sensitivity Cardiac Troponin Algorithm for Suspected Acute Coronary Syndrome in the Emergency Department.Journal of the American Heart Association · 2025Article
- Article
- Identification of patients with suspected NSTE-ACS in the observe zone: evaluating GRACE 1.0 score and a biomarker panel for risk stratification and management optimization.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Observational
- Dual antiplatelet pre-treatment with aspirin and ticagrelor in ACS patients undergoing unplanned aortocoronary bypass surgery.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Observational
- Resolving the observe zone: validation of the ESC 0/3-hour and the APACE criteria for NSTEMI triage.Open heart · 2025Observational
- Rapid rule-out of acute myocardial infarction using the 0/1-hour algorithm for cardiac troponins in emergency primary care: the OUT-ACS implementation study.BMC primary care · 2025Article
- How Close Are We to Patient-Side Troponin Testing?Journal of clinical medicine · 2024Review
- Effectiveness and Safety of the ESC-TROP (European Society of Cardiology 0h/1h Troponin Rule-Out Protocol) Trial.Journal of the American Heart Association · 2024Article
- A multicenter prospective study on the ESC algorithm for the early diagnosis of non-ST-elevation myocardial infarction.iScience · 2024Article
- Predictors of Revascularization in Patients with Unstable Angina.Journal of clinical medicine · 2024Article
- Article
- Development of the first Iranian clinical practice guidelines for the diagnosis, treatment, and secondary prevention of acute coronary syndrome.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2024Article
- Characteristics of Patients With Acute Coronary Syndrome and Normal Electrocardiogram.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2024Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough the value of fast diagnostic protocols in suspected acute coronary syndrome has been validated, there is insufficient real world evidence including patients with lower pre-test probability, atypical symptoms and confounding comorbidities. The feasibility, efficacy and safety of European Society of Cardiology (ESC) 0/1 and 0/3-hour algorithms using high-sensitivity troponin T were evaluated in a consecutive cohort with suspected acute coronary syndrome.
methodsDuring 12 months, 2525 eligible patients were enrolled. In a pre-implementation period of 6 months, the prevalence of protocols, disposition, lengths of emergency department stay and treatments were registered. Implementation of the 0/1-hour protocol was monitored for another 6 months. Primary endpoints comprised the change of diagnostic protocols and 30-day mortality after direct discharge from the emergency department.
resultsUse of the ESC 0/1-hour algorithm increased by 270% at the cost of the standard 0/3-hour protocol. After rule-out (1588 patients), 1309 patients (76.1%) were discharged directly from the emergency department, with an all-cause mortality of 0.08% at 30 days (one death due to lung cancer). Median lengths of stay were 2.9 (1.9-3.8) and 3.2 (2.7-4.4) hours using a single high-sensitivity troponin T below the limit of detection (5 ng/L) at presentation and the ESC 0/1-hour algorithm, respectively, as compared to 5.3 (4.7-6.5) hours using the ESC 0/3-hour rule-out protocol (
conclusionImplementation of the ESC 0/1-hour algorithm is feasible and safe, is associated with shorter emergency department stay than the ESC 0/3-hour protocol, and an increase in discharge rates.
trial registrationClinicalTrials.gov , Unique identifier: NCT03111862.
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