Interpretation: This rapid strategy incorporat ing highsensitivity cardiac troponin T baseline values and absolute changes within the first hour substantially accelerated the manage ment of suspected acute MI by allowing safe ruleout as well as accurate rulein of acute MI in 3 out of 4 patients. Trial registration: Clinical Trials.gov, NCT00470587 AbstractResearch

Using a simple algorithm incorporating baseline hs-cTnI values and the absolute change within the first hour allows safe rule-out as well as accurate rule-in of acute myocardial infarction in 70% of patients presenting with suspected acute myocardial infarction.