Nestelberger T, Boeddinghaus J, Wussler D, et al. – Researchers investigated whether the addition of clinical judgment and electrocardiogram results to the European Society of Cardiology (ESC) high-sensitivity cardiac troponin (hs-cTn) measurement at presentation and following 1 hour (ESC hs-cTn 0/1 h algorithm) would further enhance its performance to predict major adverse cardiac events (MACE) in patients with suspected acute myocardial infarction (AMI) in this prospective, multicenter diagnostic study. MACE (primary endpoint) was defined as all-cause mortality, cardiac arrest, AMI, cardiogenic shock, sustained ventricular arrhythmia, and high-grade atrioventricular block within 30 days including index events. Findings revealed that the ESC hs-cTn 0/1 h algorithm better balanced efficacy and safety in MACE prediction, whereas for the rule-out of 30-day MACE + unstable angina, the preferred choice was the extended algorithm.