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Cardiovascular Medicine
Volume 22
Issue 1
10.4414/cvm.2019.02010
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Cardiovascular Medicine is published by MDPI from Volume 28 Issue 1 (2025). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Editores Medicorum Helveticorum (EMH).
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Review

Optimising the Early Rule-out and Rule-in of Myocardial Infarction Using Biomarkers

by
Twerenbold Raphael
*,
Gimenez Maria Rubini
,
Nestelberger Thomas
,
Boeddinghaus Jasper
,
Wildi Karin
and
Mueller Christian
Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, 4001 Basel, Switzerland
*
Author to whom correspondence should be addressed.
Cardiovasc. Med. 2019, 22(1), w02010; https://doi.org/10.4414/cvm.2019.02010
Submission received: 26 November 2018 / Revised: 26 December 2018 / Accepted: 26 January 2019 / Published: 26 February 2019
Versions Notes

Abstract

Detailed clinical assessment, the electrocardiogram and cardiac troponin form the three cornerstones of the early diagnosis of myocardial infarction (MI). After the clinical introduction of high-sensitivity cardiac troponin (hs-cTn) assays about 8 years ago, precise quantification of cardiomyocyte injury around the 99th percentile became possible and thereby substantially increased the accuracy of MI diagnosis from blood drawn at presentation to the emergency department. Higher diagnostic accuracy enabled the development and validation of multiple early hs-cTn-based diagnostic algorithms including the ESC 0/ 1-hour algorithm, which substantially reduced the time required for safe rule-out or rule-in of MI. This algorithm is widely applicable, including in patients with renal dysfunction and in the USA, where hs-cTn approval is slightly different from the rest of the world. Apart from hs-cTn, other emerging cardiac biomarkers might have the potential to further improve the early triage of patients with suspected MI.
Keywords: high-sensitivity troponin; cardiac myosinbinding protein C; myocardial infarction; rule-out; rule-in; algorithm high-sensitivity troponin; cardiac myosinbinding protein C; myocardial infarction; rule-out; rule-in; algorithm

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MDPI and ACS Style

Raphael, T.; Maria Rubini, G.; Thomas, N.; Jasper, B.; Karin, W.; Christian, M. Optimising the Early Rule-out and Rule-in of Myocardial Infarction Using Biomarkers. Cardiovasc. Med. 2019, 22, w02010. https://doi.org/10.4414/cvm.2019.02010

AMA Style

Raphael T, Maria Rubini G, Thomas N, Jasper B, Karin W, Christian M. Optimising the Early Rule-out and Rule-in of Myocardial Infarction Using Biomarkers. Cardiovascular Medicine. 2019; 22(1):w02010. https://doi.org/10.4414/cvm.2019.02010

Chicago/Turabian Style

Raphael, Twerenbold, Gimenez Maria Rubini, Nestelberger Thomas, Boeddinghaus Jasper, Wildi Karin, and Mueller Christian. 2019. "Optimising the Early Rule-out and Rule-in of Myocardial Infarction Using Biomarkers" Cardiovascular Medicine 22, no. 1: w02010. https://doi.org/10.4414/cvm.2019.02010

APA Style

Raphael, T., Maria Rubini, G., Thomas, N., Jasper, B., Karin, W., & Christian, M. (2019). Optimising the Early Rule-out and Rule-in of Myocardial Infarction Using Biomarkers. Cardiovascular Medicine, 22(1), w02010. https://doi.org/10.4414/cvm.2019.02010

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