Circulation Reports
Online ISSN : 2434-0790
Reviews
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 ―
Osamu NomuraKatsutaka HashibaMigaku KikuchiSunao KojimaHiroyuki HanadaToshiaki ManoTakeshi YamamotoTakahiro NakashimaAkihito TanakaNaoki NakayamaJunichi YamaguchiKunihiro MatsuoTetsuya MatobaYoshio TaharaHiroshi Nonogifor the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee
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Supplementary material

2022 Volume 4 Issue 6 Pages 241-247

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Abstract

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.

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%).

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.

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© 2022, THE JAPANESE CIRCULATION SOCIETY

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