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One-hour Rule-in and Rule-out of Acute Myocardial Infarction Using High-sensitivity Cardiac Troponin I Maria Rubini Gimenez, MD, Raphael Twerenbold, MD, Cedric Jaeger, MD, Christian Schindler, PhD, Christian Puelacher, MD, Karin Wildi, MD, Tobias Reichlin, MD, Philip Haaf, MD, Salome Merk, MD, Ursina Honegger, MS, Max Wagener, MD, Sophie Druey, MD, Carmela Schumacher, MD, Lian Krivoshei, MD, Petra Hillinger, MD, Thomas Herrmann, MD, Isabel Campodarve, MD, Katharina Rentsch, PhD, Stefano Bassetti, MD, Stefan Osswald, MD, Christian Mueller, MD The American Journal of Medicine Volume 128, Issue 8, Pages e4 (August 2015) DOI: /j.amjmed Copyright © 2015 Elsevier Inc. Terms and Conditions
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Figure 1 One-hour algorithm for the diagnosis of acute myocardial infarction (AMI) using hs-cTnI in the derivation (A) and validation cohort (B). Oh = hs-cTnI at presentation to the ED; Delta 1h = absolute change of hs-cTnI within 1 hour; Sens = sensitivity; Spec = specificity; NPV = negative predictive value; PPV = positive predictive value. The American Journal of Medicine , e4DOI: ( /j.amjmed ) Copyright © 2015 Elsevier Inc. Terms and Conditions
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Figure 2 Negative predictive value (NPV) and positive predictive value (PPV) of the 1h-algorithm in study subgroups in the validation group. Forest plots indicating (A) NPV and (B) PPV among different study subgroups including interaction P-value. CAD = coronary artery disease. The American Journal of Medicine , e4DOI: ( /j.amjmed ) Copyright © 2015 Elsevier Inc. Terms and Conditions
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Figure 3 Kaplan-Meier curves for the cumulative mortality according to classification provided by the 1h hs-cTnI algorithm into “rule-out” (n = 457), “observational zone” (n = 276), and “rule-in” (n = 172) provided by the hs-cTnI 1-hour algorithm. Differences in mortality were assessed using the log-rank test. (A) mortality during first 30 days, (B) mortality during first 365 days. The American Journal of Medicine , e4DOI: ( /j.amjmed ) Copyright © 2015 Elsevier Inc. Terms and Conditions
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Supplemental Figure 1 1h alternative algorithm for the diagnosis of AMI using hs-cTnI in the derivation cohort. 0h = hs-cTnI at presentation to the ED; AMI = acute myocardial infarction; Delta 1h = absolute change of hs-cTnI within 1 hour; NPV = negative predictive value; PPV = positive predictive value; Sens = sensitivity; Spec = specificity. The American Journal of Medicine , e4DOI: ( /j.amjmed ) Copyright © 2015 Elsevier Inc. Terms and Conditions
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Supplemental Figure 2 1h alternative algorithm for the diagnosis of AMI using hs-cTnI in the validation cohort. 0h = hs-cTnI at presentation to the ED; AMI = acute myocardial infarction; Delta 1h = absolute change of hs-cTnI within 1 hour; NPV = negative predictive value; PPV = positive predictive value; Sens = sensitivity; Spec = specificity. The American Journal of Medicine , e4DOI: ( /j.amjmed ) Copyright © 2015 Elsevier Inc. Terms and Conditions
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