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Performance of the 0-Hour/1-Hour Algorithm for Diagnosing Myocardial Infarction in Patients With Chest Pain in the Emergency Department ― A Systematic Review and Meta-Analysis ―
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- Nomura Osamu
- Department of Emergency and Disaster Medicine, Hirosaki University
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- Hashiba Katsutaka
- Department of Cardiology, Saiseikai Yokohama-shi Nanbu Hospital
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- Kikuchi Migaku
- Department of Cardiovascular Medicine, Emergency and Critical Care Center, Dokkyo Medical University
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- Kojima Sunao
- Department of Internal Medicine, Sakurajyuji Yatsushiro Rehabilitation Hospital
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- Hanada Hiroyuki
- Department of Emergency and Disaster Medicine, Hirosaki University
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- Mano Toshiaki
- Kansai Rosai Hospital Cardiovascular Center
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- Yamamoto Takeshi
- Division of Cardiovascular Intensive Care, Nippon Medical School Hospital
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- Nakashima Takahiro
- Department of Emergency Medicine and Michigan Center for Integrative Research in Critical Care, University of Michigan
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- Tanaka Akihito
- Department of Cardiology, Nagoya University Graduate School of Medicine
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- Nakayama Naoki
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center
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- Yamaguchi Junichi
- Department of Cardiology, Tokyo Women’s Medical University
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- Matsuo Kunihiro
- Department of Acute Care Medicine, Fukuoka University Chikushi Hospital
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- Matoba Tetsuya
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
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- Tahara Yoshio
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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- Nonogi Hiroshi
- Faculty of Health Science, Osaka Aoyama University
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Description
<p>Background: This study assessed the diagnostic performance of the 0-hour/1-hour (0/1-h) algorithm to rule in and rule out acute myocardial infarction (MI) in patients presenting to the emergency department (ED) for suspected acute coronary syndrome without ST-segment elevation, as recommended in the 2015 European Society of Cardiology (ESC) guideline.</p><p>Methods and Results: Following the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy (PRISMA-DTA) guidelines, a systematic review was conducted using the PubMed database from inception to March 31, 2020. We included any article published in English investigating the diagnostic performance of the ESC 0/1-h algorithm for diagnosing MI in patients with chest pain visiting the ED. Of 651 studies identified as potentially available for the study, 7 studies including 16 databases were analyzed. A meta-analysis of the diagnostic accuracy of the 0/1-h algorithm using high-sensitivity cardiac troponin I (hs-cTn) with 6 observational databases showed a pooled sensitivity of 99.3% (95% confidence interval [CI] 98.5–99.7%) and a pooled specificity of 90.1% (95% CI 80.7–95.2%). A meta-analysis of the diagnostic accuracy of 10 observational databases of the ESC 0/1-h algorithm using hs-cTn revealed a pooled sensitivity of 99.3% (95% CI 96.9–99.9%) and a pooled specificity of 91.7% (95% CI 83.5–96.1%).</p><p>Conclusions: Our results demonstrate that the ESC 0/1-h algorithm can effectively rule in and rule out patients with non-ST-segment elevation MI.</p>
Journal
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- Circulation Reports
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Circulation Reports 4 (6), 241-247, 2022-06-10
The Japanese Circulation Society
