The latest European Society of Cardiology guideline on the management of acute coronary syndromes without persistent ST-elevation stipulates several acceptable pathways through which patients presenting with chest pain can be assessed for unstable coronary disease. This article reviews the data behind the “rule-in and rule-out algorithm,” which can exclude acute myocardial infarction within 1 hour of presentation through the use of fifth generation high-sensitivity troponin assays.
From the *John Radcliffe Hospital, Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
†Royal Berkshire NHS Foundation Trust, Reading, United Kingdom.
Received for publication June 2, 2018; accepted August 18, 2018.
Reprints: Asad Shabbir, MBBS, MRCP, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, United Kingdom. E-mail: firstname.lastname@example.org.