Table 2

Overview on the performance of fast rule-out strategies based on single and serial blood draw at 0 hour/1 hour

Test principleCompanyMeta-analysis cohortsTroponin (ng/L)Sensitivity (pooled)NPV (pooled)Proportion eligible for rule-outEvent rate
after rule-out
MACEDeathMI
0-hour rule-out: single hs-cTNT <LoD (SMS)
Pickering, et al29hs-cTnT11 cohorts
9241 patients
<LoD
(<5 ng/L)
98.7%
(96.6 to 99.5)
99.3%
(97.3 to 99.8)
30.60%21/80591.30%14/8059
ESC 0/1 hour: either very low 0 hour <LoD or low hs-cTn and small δ between 0 and 1 hour
Chiang, et al28
15 cohorts: 11 014 patients
hs-cTnIAbbott4 cohortsEither very low
0 hour (<2 ng/L), or low hs-cTnI
(<5 ng/L) and small δ (<2 ng/L) between 0 and 1 hour
98.1%
(94.6 to 99.3)
99%
(96.0 to 100)
50.00%NA0.10%NA
hs-cTnISiemens4 cohortsEither very low
0 hour (<0.5 ng/L), or low hs-cTnI (<5 ng/L) and small δ (<2 ng/L) between 0 and 1 hour
98.7%
(97.3 to 99.3)
100%
(99 to 100)
51.00%NA0.10%NA
hs-cTnTRoche7 cohorts
7744 patients
Either very low
0 hour (<5 ng/L), or low hs-cTnT
(<12 ng/L) and small δ (<3 ng/L) between 0 and 1 hour
98.4%
(95.1 to 99.5)
99.6%
(99.0 to 99.9)
55.00%NA0.10%NA
  • ESC, European Society of Cardiology; hs-cTnI, high-sensitivity cardiac troponin I; LoD, limit of detection; MACE, major adverse cardiac events; MI, myocardial infarction; NA, not available; NPV, negative predictive value; SMS, single marker strategy.