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0 h/1 h or 0 h/2 h rule-out and rule-in algorithms

Step1: Input the hs-cTn value (ng/L)

0/1 h hs-cTn

0/2 h hs-cTn

Select the assays

0/1 h hs-cTn

Very low initial hs-cTn

OR

Low initial hs-cTn and 

no increase in 1h hs-cTn

Rule-out

Patients who do not meet the criteria for either of the other two pathways

Observe

High initial hs-cTn

OR

Increase in 1 h hs-Tn

Rule-in

0/2 h hs-cTn

Very low initial hs-cTn

OR

Low initial hs-cTn and 

no increase in 2h hs-cTn

Rule-out

Patients who do not meet the criteria for either of the other two pathways

Observe

High initial hs-cTn

OR

Increase in 2 h hs-Tn

Rule-in

Assay specific cut-off levels in ng/L within the 0 h/1 h and 0 h/2 h algorithms

The table above is sourced from the 2023 ESC Guidelines for the management of acute coronary syndromes. For more detailed information, you can access the complete information at the following link: [2023 ESC Guidelines for the management of acute coronary syndromes Supplementary data]

How it work

References

Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, Claeys MJ, Dan GA, Dweck MR, Galbraith M, Gilard M, Hinterbuchner L, Jankowska EA, Jüni P, Kimura T, Kunadian V, Leosdottir M, Lorusso R, Pedretti RFE, Rigopoulos AG, Rubini Gimenez M, Thiele H, Vranckx P, Wassmann S, Wenger NK, Ibanez B; ESC Scientific Document Group. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023 Oct 12;44(38):3720-3826. doi: 10.1093/eurheartj/ehad191. Erratum in: Eur Heart J. 2024 Apr 1;45(13):1145. doi: 10.1093/eurheartj/ehad870. PMID: 37622654.

©2023 BY Piti Niyomsirivanich, MD. (Personal use)
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