Article Text

other Versions

Download PDFPDF
Journal Club
Evaluation of a 0-hour/1-hour algorithm in the diagnosis of myocardial infarction with high-sensitivity cardiac troponin T1
  1. Jaspreet Kaur Khaira
  1. Correspondence to Dr Jaspreet Kaur Khaira, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK; jaspreet.khaira{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Using a highly sensitive assay of serum troponin T in patients with suspected myocardial infarction might help in early diagnosis, but the method needs thorough clinical assessment before implementation.

Summary box

  • A highly sensitive serum troponin T assay has been claimed to be useful in ruling a myocardial infarction in or out soon after presentation.

  • However, performance measures for diagnostic tests should be thought of in terms of real patients, and not taken at face value.

  • Changes in biomarker concentrations over time may be superior to single cut-off values.

Summary of evidence

The High Sensitivity Cardiac Troponin T Assay for Rapid Rule-out of Acute Myocardial Infarction trial was a prospective, multicentre, diagnostic study done at 12 sites, across three continents to validate the diagnostic accuracy of the troponin T 0-hour/1-hour algorithm for rule-in and rule-out of acute myocardial infarction.1

Current troponin assays for the diagnosis of myocardial infarction usually require serial sampling between 8 and 24 hours, depending on the specific assay/local protocols. This time interval contributes to ‘rule-in’ delays, delaying treatment, and ‘rule-out’ delays, costing time, …

View Full Text


  • Contributors JKK presented the study at the OUH F1 Journal Club on 7 September 2017 and wrote the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.