Performance of 0/1 h versus 0/3 h pathways in patients with suspected myocardial infarction: a systematic review and individual participant data meta-analysis of randomised controlled trials.
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This systematic review and individual participant data meta-analysis of five randomised trials (about 111,000 presentations) asked whether the faster 0/1 h troponin pathway is safer than the standard 0/3 h pathway for patients with suspected myocardial infarction. The 0/1 h pathway was associated with a numerically lower rate of 30-day death or new type 1 myocardial infarction (0.8% vs 1.0%, pooled OR 0.83, 95% CI 0.45-1.53), but the estimate was imprecise. It did not meaningfully shorten emergency department length of stay or clearly increase direct discharge, and substantial heterogeneity across trials suggests results may vary by health-care system.
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