ESC 0/1-Hour Protocol Shows Higher Sensitivity Than High-STEACS Pathway

The rapid and reliable exclusion of myocardial infarction in the emergency department is a critical clinical priority to ensure patient safety and optimize hospital resources [1]. High-sensitivity cardiac troponin assays have transformed this process by allowing for much lower diagnostic thresholds than conventional tests, although this increased sensitivity often comes at the expense of specificity [2]. Current clinical practice guidelines recommend various accelerated diagnostic pathways, such as the 0/1-hour algorithm, which has demonstrated high negative predictive value in large observational meta-analyses [3]. However, the implementation of these high-sensitivity assays and their corresponding sex-specific thresholds remains complex, as clinicians must balance the need for rapid triage with the risk of underdiagnosing certain populations [4, 5]. To clarify these clinical trade-offs, a new multicenter study provides a direct comparison of the leading rapid diagnostic protocols, helping physicians choose the best pathway for their specific emergency department needs.