{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:44:56Z","timestamp":1781768696407,"version":"3.54.5"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T00:00:00Z","timestamp":1702425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The diagnostic performance of the high\u2010sensitivity troponin T (hs\u2010cTnT) European Society of Cardiology (ESC) 0\/1\u2010h algorithm in sex and race subgroups of US\u00a0Emergency Department (ED) patients is unclear. A pre\u2010planned subgroup analysis of the STOP\u2010CP cohort study was conducted. Participants with 0\u2010 and 1\u2010h hs\u2010cTnT measures from eight US\u00a0EDs (1\/2017 to 9\/2018) were stratified into rule\u2010out, observation, and rule\u2010in zones using the hs\u2010cTnT ESC 0\/1 algorithm. The primary outcome was adjudicated 30\u2010day cardiac death or MI. The proportion with the primary outcome in each zone was compared between subgroups with Fisher's exact tests. The negative predictive value (NPV) of the ESC 0\/1 rule\u2010out zone for 30\u2010day CDMI was calculated and compared between subgroups using Fisher's exact tests. Of the 1422 patients enrolled, 54.2% (770\/1422) were male and 58.1% (826\/1422) white with a mean age of 57.6 \u00b1 12.8 years. At 30 days, cardiac death or myocardial infarction\u00a0(MI) occurred in 12.9% (183\/1422) of participants. Among patients stratified to the rule\u2010out zone, 30\u2010day cardiac death or MI occurred in 1.1% (5\/436) of women versus 2.1% (8\/436) of men (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.40) and 1.2% (4\/331) of non\u2010white patients versus 1.8% (9\/490) of white patients (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.58). The NPV for 30\u2010day cardiac death or MI was similar among women versus men (98.9% [95% confidence interval,\u00a0CI: 97.3\u201399.6] vs. 97.9% [95%\u00a0CI: 95.9\u201399.1];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.40) and among white versus\u00a0non\u2010white patients (98.8% [95%\u00a0CI: 96.9\u201399.7] vs. 98.2% [95%\u00a0CI: 96.5\u201399.2];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.39). NPVs &lt;99% in each subgroup suggest the hs\u2010cTnT ESC 0\/1\u2010h algorithm may not be safe for use in US\u00a0EDs.\u00a0Trial Registration: High\u2010Sensitivity Cardiac Troponin T to Optimize Chest Pain Risk Stratification (STOP\u2010CP;\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                    : NCT02984436;\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02984436\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02984436<\/jats:ext-link>\n                    ).\n                  <\/jats:p>","DOI":"10.1002\/clc.24199","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T08:42:26Z","timestamp":1702456946000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Sex and race differences in the performance of the European Society of Cardiology 0\/1\u2010h\u00a0algorithm with high\u2010sensitivity troponin T"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5999-4554","authenticated-orcid":false,"given":"Michael W.","family":"Supples","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna C.","family":"Snavely","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"},{"name":"Department of Biostatistics and Data Science Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicklaus P.","family":"Ashburn","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"},{"name":"Section on Cardiovascular Medicine, Department of Internal Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon R.","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Florida College of Medicine Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Christenson","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Maryland School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Henry Ford Health System Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Gentry","family":"Wilkerson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Maryland School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryn E.","family":"Mumma","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of California Davis School of Medicine Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy","family":"Madsen","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine University of Utah School of Medicine Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason P.","family":"Stopyra","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon A.","family":"Mahler","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"},{"name":"Department of Epidemiology and Prevention Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"},{"name":"Department of Implementation Science Wake Forest School of Medicine Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000757"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000950"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000659"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa575"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv320"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.05.046"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.05.040"},{"key":"e_1_2_10_9_1","article-title":"Performance of the European Society of Cardiology 0\/1\u2010hour algorithm in the diagnosis of myocardial infarction with high\u2010sensitivity cardiac troponin: systematic review and meta\u2010analysis","volume":"29","author":"Burgos LM","year":"2020","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.022677"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.07.053"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/M21-1499"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2019.12.008"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.09.171"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.049298"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7873"},{"issue":"3","key":"e_1_2_10_17_1","article-title":"Abstract 13919: race and gender specific high sensitivity troponin\u2010t cutoff values improve detection in patients\u2019 with ischemic heart disease","volume":"142","author":"Kong N","year":"2020","journal-title":"Circulation"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2020-206951"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.12.032"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.114.001384"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41073-016-0014-7"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2019.05.026"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2012.3698"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048872616649859"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.025021"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0802743"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.1038"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(91)90128-V"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jspi.2011.05.010"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036528"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.01.046"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.141349"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.042891"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12164"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13343"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.01.059"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2012.192716"},{"issue":"1","key":"e_1_2_10_38_1","article-title":"Analytical characteristics of high\u2010sensitivity cardiac troponin assays","volume":"4","author":"Apple FS","year":"2014","journal-title":"Lab Med"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/hvab109"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2019.305543"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012874"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.24199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T06:10:33Z","timestamp":1713161433000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.24199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,13]]},"references-count":40,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/clc.24199"],"URL":"https:\/\/doi.org\/10.1002\/clc.24199","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2023.04.28.23289294","asserted-by":"object"}]},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,13]]},"assertion":[{"value":"2023-08-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e24199"}}