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Updated: Jan 29, 2026

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One-Hour High Sensitivity Troponin Testing: A Safe and Effective Triage Tool for the Emergency Department

Asad Shabbir1,2, Lampson Fan1, Gregory Fraser1

  • 1From the John Radcliffe Hospital, Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom.

Critical Pathways in Cardiology
|February 13, 2019
PubMed

Insights

The new European Society of Cardiology guideline offers a rapid algorithm to assess chest pain patients. Fifth-generation high-sensitivity troponin assays can rule out acute myocardial infarction within one hour.

Area of Science:

  • Cardiology
  • Emergency Medicine

Background:

  • Acute coronary syndromes without persistent ST-elevation require timely assessment.
  • European Society of Cardiology guidelines provide frameworks for managing these conditions.

Purpose of the Study:

  • To review the evidence supporting the "rule-in and rule-out algorithm" for unstable coronary disease.
  • To highlight the utility of fifth-generation high-sensitivity troponin assays in rapid diagnosis.

Main Methods:

  • Review of data supporting the "rule-in and rule-out algorithm".
  • Focus on the application of fifth-generation high-sensitivity troponin assays.

Main Results:

  • The algorithm enables exclusion of acute myocardial infarction within 1 hour.
  • Fifth-generation assays are key to this rapid diagnostic capability.

Conclusions:

  • The guideline-recommended algorithm facilitates efficient assessment of chest pain patients.
  • High-sensitivity troponin assays significantly shorten the diagnostic timeline for acute myocardial infarction.

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