{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T06:59:34Z","timestamp":1785481174289,"version":"3.56.0"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>A 0\/2\u2010h algorithm for the i\u2010STAT point\u2010of\u2010care (POC) high sensitivity troponin I (hs\u2010cTnI) assay was recently derived in Australia. The objective of this study was to validate and optimize the performance of the 0\/2\u2010h algorithm in a multisite U.S. Emergency Department (ED) cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study was conducted at three U.S. EDs (February\u2013September 2025). Adults without STEMI and at least one hs\u2010cTnI ordered were accrued. Blood samples were collected simultaneously for POC hs\u2010cTnI measurement on an i\u2010STAT 1 analyzer (Abbott Laboratories) and central laboratory hs\u2010cTnI measurement (Beckman Coulter). The primary outcome was index myocardial infarction (MI), adjudicated by experts using clinical hs\u2010cTnI measures. Diagnostic performance of the Australian 0\/2\u2010h algorithm was assessed by calculating negative and positive predictive values (NPV, PPV) with associated 95% confidence intervals. Efficacy, defined as the proportion of patients classified into the rule\u2010out zone, was calculated. Algorithm optimization tested modified cut points to increase efficacy while maintaining NPV \u2265\u200999% and achieving PPV \u2265\u200965%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the study period, 578 patients with complete 0\/2\u2010h algorithm assessments were accrued. These patients were 48% (279\/578) female, 40% (233\/578) non\u2010White, with a median age of 60\u2009years (IQR: 50\u201370). Index MI occurred in 7.4% (43\/578). Algorithm efficacy was 54.8% (317\/578) and 8.8% (51\/578) were classified to the rule\u2010in zone. Among patients ruled\u2010out, the NPV was 99.4% (95% CI: 97.7%\u201399.9%). The rule\u2010in zone was associated with a PPV of 62.7% (95% CI: 48.1%\u201375.9%). Among 36.3% (210\/578) patients classified to the observation zone, 4.3% (9\/210) had an adjudicated index MI. An optimized 0\/2\u2010h algorithm increased efficacy to 60.0% (347\/578) while achieving an NPV of 99.4% (95% CI: 97.9%\u201399.9%) and PPV of 74.4% (95% CI: 58.8, 86.5%) for index MI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The original Australian and optimized 0\/2\u2010h algorithms for i\u2010STAT POC hs\u2010cTnI measurement had high NPV and efficacy in a multisite U.S. cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      <jats:styled-content style=\"fixed-case\">NCT06899776<\/jats:styled-content>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70379","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T08:34:19Z","timestamp":1784363659000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of a 0\/2\u2010Hour Point\u2010Of\u2010Care High Sensitivity Troponin Algorithm: A Multisite\n                    <scp>US<\/scp>\n                    Study"],"prefix":"10.1111","volume":"33","author":[{"given":"Simon A.","family":"Mahler","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"},{"name":"Department of Implementation Science Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"},{"name":"Department of Epidemiology and Prevention Wake Forest University School of Medicine  Winston\u2010Salem North Carolina 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