In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Safety and efficacy of the esc 0h/3h-protocol for rapid rule-out of myocardial infarction among women and men

Session Poster session 3

Speaker Maria Rubini Gimenez

Event : ESC Congress 2015

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Non-ST-Elevation Myocardial Infarction (NSTEMI)
  • Session type : Poster Session

Authors : M Rubini Gimenez (Basel,CH), R Twerenbold (Basel,CH), K Wildi (Basel,CH), T Reichlin (Basel,CH), C Puelacher (Basel,CH), P Hillinger (Basel,CH), M Wagener (Basel,CH), J Boeddinghaus (Basel,CH), S Osswald (Basel,CH)

Authors:
M. Rubini Gimenez1 , R. Twerenbold1 , K. Wildi1 , T. Reichlin1 , C. Puelacher1 , P. Hillinger1 , M. Wagener1 , J. Boeddinghaus1 , S. Osswald1 , 1University Hospital Basel, Department of Cardiology - Basel - Switzerland ,

Citation:
European Heart Journal ( 2015 ) 36 ( Abstract Supplement ), 406

Background: We aimed to prospectively evaluate the safety and efficacy of the new ESC rapid 0h/3h-rule-out protocol for AMI based on the 99th percentile of high sensitivity cardiac troponins (hs-cTn), among women and men in order to assess potential gender-inequalities.

Methods: We enrolled consecutive patients presenting to the ED with suspected AMI in a prospective international multicenter study. Excluded were patients with ST-segment elevation, no available baseline hs-cTnT levels, and no available data about onset/peak of pain. Among the remaining 2727 patients, 32% were women and 68% men. The final diagnosis was adjudicated by two independent cardiologists. The safety and efficacy of the ESC 0h/3h-rule-out protocol was evaluated among women and men.

Results: AMI was the final diagnosis in 17% of patient (15% of women and 19% of men (p<0.001)). Using the 99th percentile of hs-cTnT (14ng/l), the ESC 0h-rule-out protocol correctly ruled-out 99.4% (95% CI, 96.8–100%) of late presenters (≥6h from chest pain onset) among women and 100% (95% CI, 99.8–100%) among men (p=ns). The ESC 3h-rule-out protocol correctly ruled-out 100% (95% CI 98.3–100%) of early presenters (<6h from chest pain onset) among women and 99.8% (95% CI, 98.9–100%) among men (p=ns). Overall, the ESC rule-out protocol classified about 44% of women and 43% of men with suspected AMI.

Conclusions: The current ESC 0h/3h-rule-out protocol using the 99th percentile of hs-cTn in conjunction with clinical assessment is safe and effective and provides comparable results among women and men. A common strategy for both genders seems to be the most appropriate choice.

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are