Performance of a high-sensitivity troponin-based early rule-out pathway for suspected myocardial infarction.

Cohort studyActa cardiologica· Aug 2026

Performance of a high-sensitivity troponin-based early rule-out pathway for suspected myocardial infarction.

Nicholas Seton, Maria Gabriela Matta, Shobiga Sarvananda … Rohan Jayasinghe

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Acute Chest Pain & TroponinCohort studyQ3IF 1.4

30-day type I myocardial infarction rate was very low across all Suspected Acute Myocardial Infarction in Emergency risk groups

Performance of a high-sensitivity troponin-based early rule-out pathway for suspected myocardial infarction.

Nicholas Seton … Rohan Jayasinghe

Acta cardiologica · Aug 2026 · Q3 in General Medicine

Background

High-sensitivity cardiac troponins enable early rule-out of myocardial infarction (myocardial infarction), but their effect on diagnostic specificity remains uncertain.

Methods

Were classified as low-risk (troponin <5 ng/L), intermediate-risk (troponin ≥5 ng/L and Δ troponin <3 ng/L), or high-risk (troponin ≥5 ng/L and Δ troponin ≥3 ng/L or above sex-specific thresholds).

n = 355 patients

Results

0.6%

30-day heart attack was rare even in high-risk patients

n = 355 patients

More results

Among 355 patients (mean age 59.4 ± 17.5 years), 64 (18.0%) were low-risk, 121 (34.1%) intermediate-risk, and 170 (47.9%) high-risk.

Rates of obstructive coronary artery disease and positive stress echocardiography were similar across risk categories.

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Conclusion · 1 of 3

Among a selected cohort managed through a structured rapid-access chest pain outpatient service, 30-day type I myocardial infarction rates were low across all Suspected Acute Myocardial Infarction in Emergency risk categories.

Conclusion · 2 of 3

Both events occurred in the Suspected Acute Myocardial Infarction in Emergency high-risk group.

Conclusion · 3 of 3

Given the small number of events, these findings should be considered hypothesis-generating and require validation in larger prospective studies.

Performance of a high-sensitivity troponin-based early rule-out pathway for suspected myocardial infarction.

Performance of a high-sensitivity troponin-based early rule-out pathway for suspected myocardial infarction.

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