ArticleBMC emergency medicine2025
The diagnostic accuracy of the ESC 0/1-hour algorithm in non-ST-segment elevation myocardial infarction in a crowded emergency department: a real-world experience from a single-center in Türkiye.
Article in BMC emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed.
- Diagnostic Performance of Complete Blood Count Derived Indices for Acute Coronary Syndrome in Emergency Department Patients With Acute Chest Pain: A Single-Center Retrospective Diagnostic Accuracy Study.Health science reports · 2026Article
- Clinical Gray Zones of Cardiac Troponin Interpretation in the Emergency Department: When Increased Concentrations Do Not Equal Acute Coronary Syndrome.Journal of clinical medicine · 2026Review
- Inferior ST-Segment Elevation Myocardial Infarction Presenting as Isolated Elbow Pain: A Case Report.Cureus · 2026Article
- Red blood cell distribution width-to-albumin ratio and in-hospital major adverse cardiovascular events in patients with acute myocardial infarction complicated by cardiogenic shock: a two-center retrospective cohort study.Frontiers in cardiovascular medicine · 2026Article
- Invasive versus non-invasive management in non-ST segment elevation myocardial infarction patients with pulmonary hypertension.SAGE open medicine · 2026Article
- SVEAT score for early risk stratification of acute chest pain: a multicenter study.BMC emergency medicine · 2025Observational
- Article
- Early Sepsis Detection in Adult Patients with Suspected Sepsis in an Emergency Setting: A Sequential Strategy of Monocyte Distribution Width and Presepsin.Diagnostics (Basel, Switzerland) · 2025Article
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Abstract
backgroundThe rapid and accurate diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) is critical to improving patient outcomes and reducing emergency department (ED) overcrowding. The European Society of Cardiology (ESC) 0/1-hour algorithm, utilizing high-sensitivity cardiac troponin T (hs-cTnT) levels, has demonstrated high diagnostic performance internationally. This study aimed to evaluate its diagnostic accuracy in a high-volume ED setting in Türkiye.
methodsThis single-center retrospective cohort study was conducted at Marmara University Pendik Training and Research Hospital, Türkiye, from September 1 to December 31, 2022. Adults presenting with acute chest discomfort and undergoing hs-cTnT testing per the ESC 0/1-hour algorithm were included. Patients with ST-segment elevation, missing data, pregnancy, or those discharged against medical advice were excluded. The primary outcome was NSTEMI diagnosis; the secondary outcome was major adverse cardiac events (MACE) within 30 days.
resultsOf 3,529 eligible patients, 3,216 were included. The mean age of the patients was 53.9 ± 16.4 years, and 58.3% were male. NSTEMI was diagnosed in 319 patients (9.9%). According to the ESC algorithm, 54.4% of patients were classified as "rule-out," 31.3% as "observe," and 12.3% as "rule-in." The sensitivity and negative predictive value (NPV) for NSTEMI in the "rule-out" group were both 100%. In the "rule-in" group, the specificity was 91.16%, and the positive predictive value (PPV) was 59.14%. MACE occurred in 13.6% (436 patients) within 30 days: 0.7% in the "rule-out" group, 13.9% in the "observe" group, and 67.0% in the "rule-in" group.
conclusionsThe ESC 0/1-hour algorithm is highly effective for ruling out NSTEMI in Türkiye, demonstrating excellent sensitivity and NPV. While it facilitates early discharge of low-risk patients, enhancements are needed for risk stratification in intermediate-risk groups. Its implementation could optimize ED resource utilization and improve clinical outcomes. CLINICAL TRIAL NUMBER: Not applicable.
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