Introduction:

The greatest utility of high-sensitivity troponins (Tn-hs) is to rule out acute myocardial infarction (AMI) early. The algorithm recommended by the Colombian practice guideline clinical (CPG) of Health’s Ministry to rule out AMI is supported by low-quality evidence and has not been validated in the Colombian population. This research aims to evaluate the ability of this algorithm using high sensitivity troponin I (TnI-hs) to rule out AMI without ST segment elevation (STEMI).

Methods:

Patients with suspected acute coronary syndrome (ACS) treated in an emergency department of a highly complex center were analyzed. The primary outcome was the diagnosis of STEMI type 1 and type 4b. The operativing characteristics for the algorithm cut-off points were determined for the primary outcome, hospital readmission death at and 30 days.

Results:

2282 patients were included in whom the primary outcome occurred in 389. The Colombian CPG algorithm had S of 90.9% (95% CI 74-100) and NPV of 99% (95% CI 99-100) using the 99th percentile (p99) not discriminated by sex, but both S and NPV improved 100% when p99 was used by sex.

Conclusion:

The algorithm recommended by the Colombian CPG using TnI-hs and with the p99 adjusted for sex has an excellent capacity to rule out early and safely the diagnosis of STEMI.

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