Diagnostic validation and prognostic implications of serial 0/1/3h stratification in patients with suspected myocardial infarction using high-sensitivity troponin T.

Among 2,514 patients (median age 64 years; 63.6% men), the algorithm demonstrated excellent rule-out safety (sensitivity 98.6% [95% CI, 96.8, 99.4]; NPV 99.7% [99.2, 99.9]) and moderate rule-in capacity (specificity 89.3% [87.9, 90.5]; PPV 60.8% [56.8, 64.7]).

Over three years, 646 patients experienced major adverse cardiovascular events, and 256 died (68 cardiac deaths).