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One-Hour High Sensitivity Troponin Testing

A Safe and Effective Triage Tool for the Emergency Department

Shabbir, Asad, MBBS, MRCP*,†; Fan, Lampson, MBBS, MA, Dphil, MRCP*; Fraser, Gregory, MBChB*; Cassar, Mark Philip, MD(Melit), MRCP, PgCert; Swinburn, Jon, MA, MD, MRCP

Critical Pathways in Cardiology: March 2019 - Volume 18 - Issue 1 - p 16–18
doi: 10.1097/HPC.0000000000000162
Review Article

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:

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