In search for the Holy Grail: Suggestions for studies to define delta changes to diagnose or exclude acute myocardial infarction: a position paper from the study group on biomarkers of the Acute Cardiovascular Care Association

Key Points

• To establish standardized study design recommendations for defining optimal cardiac biomarker delta changes to accurately diagnose or rule out acute myocardial infarction.
• Expert consensus evaluation conducted by the Acute Cardiovascular Care Association Study Group on Biomarkers.
• Review and synthesis of methodologies for calculating serial biomarker change criteria (absolute vs. relative delta) across rapid diagnostic algorithms.
• Provides criteria for standardizing the clinical and analytical validation of serial high-sensitivity troponin changes.
• Highlights study design frameworks required to optimize rapid rule-in and rule-out diagnostic pathways in acute emergency settings.