A rapid 0/1 h algorithm for suspected non-ST-segment elevation myocardial infarction using high-sensitivity cardiac troponin I

Figures

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  Fig. 1. Flow chart of study participants. ED Emergency Department, STEMI ST-segment elevation myocardial infarction.

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  Fig. 2. Measurements of Access hs-cTnI at presentation (0 h) in patients with suspected NSTEMI. Boxplots showing concentrations of hs-cTnI Access at presentation according to the final diagnoses. Boxes represent medians and interquartile ranges (IQRs), while whiskers display the smallest and the largest non-outliers. NSTEMI non-ST-segment elevation myocardial infarction, UA unstable angina, Cardiac but not ACS cardiac related diseases excluding acute coronary syndrome, e.g. stable angina, Non-Cardiac non-cardiac related diseases, e.g. intercostal neuralgia, pneumonia and so on.

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  Fig. 3. Diagnostic accuracy of access hs-cTnI at presentation for the diagnosis of acute myocardial infarction. AUC area under the ROC curve.

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  Fig. 4. Diagnostic accuracy of hs-cTnI assays at presentation, 1 h, Δ1h and combination of 0 h and Delta 1 h for the diagnosis of acute myocardial infarction. AUC area under the ROC curve.

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  Fig. 5. Diagnostic performance of the 0/1 h algorithm using hs-cTnI based on ESC, Anzhen-01 and Anzhen-02 cut-off values in the Chinese population. a Performance of the ESC high-sensitivity cardiac troponin I Access 0/1 h algorithm in the Chinese population. ESC European Society of Cardiology, NSTEMI non-ST-segment elevation myocardial infarction, NPV negative predictive value, Sens sensitivity, PPV positive predictive value, Spec specificity. b Performance of the AnZhen 0/1h-01 algorithm in the Chinese population. NSTEMI non-ST-segment elevation myocardial infarction, NPV negative predictive value, Sens sensitivity, PPV positive predictive value, Spec specificity. c Performance of the AnZhen 0/1h-02 algorithm in the Chinese population. NSTEMI non-ST-segment elevation myocardial infarction, NPV negative predictive value, Sens sensitivity, PPV positive predictive value, Spec specificity.

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  Fig. 6. Short-term and long-term Kaplan–Meier survival curves of patients classified according to the Anzhen hs-cTnI-Access 0/1 h algorithm. According to the AnZhen hs-cTnI-Access 0/1h algorithm, cumulative event during 30 days to 3 years of follow-up was plotted in Kaplan-Meier curves, and the differences of cumulative event between each groups was counted by log-rank test.