Emergency Department Triage of Patients With Acute Chest Pain Based on the ESC 0/1-hour Algorithm (PRESC1SE-MI) (PRESC1SE-MI)

January 23, 2026 updated by: University Hospital, Basel, Switzerland

PRospective Evaluation of the European Society of Cardiology 0/1-hour Algorithm's Safety and Efficacy for Triage of Patients With Suspected Myocardial Infarction (PRESC1SE-MI)

The PRESC1SE-MI study compares two algorithms for triage of patients presenting with chest pain and symptoms of heart attack (myocardial infarction) to the emergency department. Both algorithms are recommended by the European Society of Cardiology: the 0/3-hour algorithm and the 0/1-hour algorithm.

Currently, most emergency departments worldwide use the 0/3-hour troponin algorithm. Cardiac troponin (cTn) is a heart-specific biomarker which indicates damage of the heart muscle and which increases after a heart attack. In the 0/3-hour algorithm, the amount of troponin in the bloodstream is measured with a high-sensitivity assay at admission and 3 hours thereafter. Likewise, the 0/1-hour algorithm means that the blood sample in which the troponin is measured is collected at admission and 1 hour later. Since recent clinical studies suggest that the 0/1-hour algorithm is superior to the 0/3-hour algorithm, many hospitals consider switching to the 0/1-hour algorithm.

The aim of this study is to assess how feasible the time-saving 0/1-hour algorithm would be in reality and whether it provides the same accuracy and safety in the diagnosis of myocardial infarction as the current practice the 0/3-hour algorithm.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

64374

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Australia
      • Brisbane, Australia
        • St Andrew's War Memorial Hospital Brisbane
  • Austria
      • Vienna, Austria
        • Vienna General Hospital (AKH Wien)
  • Finland
      • Helsinki, Finland
        • University Central Hospital Helsinki
  • Greece
      • Athens, Greece
        • Attikon General Hospital Athens
  • Italy
      • Florence, Italy
        • Careggi University Hospital Florence
      • Roma, Italy
        • Azienda Ospedaliera San Giovanni Addolorata
      • Torino, Italy
        • Hospital Città della Salute e della Scienza di Torino
  • Romania
      • Bucharest, Romania
        • Emergency Institute for Cardiovascular Diseases C.C. Iliescu
  • South Korea
      • Seoul, South Korea
        • Konkuk University Medical Center
  • Spain
      • Barcelona, Spain
        • Hospital Clinic Barcelona
      • Madrid, Spain
        • University Hospital Ramón y Cajal
      • Madrid, Spain
        • University Hospital October 12 Madrid
      • Valencia, Spain
        • Hospital Clínico Universitario Valencia
  • Switzerland
      • Aarau, Switzerland
        • Kantonsspital Aarau
      • Basel, Switzerland
        • St. Claraspital
      • Lucerne, Switzerland
        • Kantonsspital Luzern
      • Zurich, Switzerland
        • University Hospital Zurich
  • United Kingdom
      • London, United Kingdom
        • Royal London Hospital
      • Truro, United Kingdom
        • Royal Cornwall Hospitals Treliske
  • United States
    • Texas
      • Houston, Texas, United States, 77030
        • Baylor St. Luke's Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

14 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Study Population

Patients admitted to the emergency department with acute chest discomfort and suspected Acute Myocardial Infarction

Description

Inclusion Criteria:

  • Patients aged 18 and above
  • Presentation with acute non-traumatic acute chest pain to the emergency department
  • Suspicion of acute myocardial infarction

Exclusion Criteria:

  • Terminal kidney failure requiring dialysis
  • Cardiac arrest
  • Cardiogenic shock

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: 0/1-hour algorithm
High-sensitivity cardiac troponin (hs-cTn) blood tests are performed at admission (0 h) and 1 hour later in the emergency department.
Diagnostic test: European Society of Cardiology hs-cTnT/I 0 h/1 h algorithm
High-sensitivity cardiac troponin (hs-cTn) blood tests are performed at admission (0 h) and 1 hour later in the emergency department.
Other Names:
  • 0/1-hour algorithm
Active Comparator: 0/3-hour algorithm
High-sensitivity cardiac troponin (hs-cTn) blood tests are performed at admission (0 h) and 3 hours later in the emergency department.
Diagnostic test: European Society of Cardiology hs-cTnT/I 0 h/3 h algorithm
High-sensitivity cardiac troponin (hs-cTn) blood tests are performed at admission (0 h) and 3 hours later in the emergency department.
Other Names:
  • 0/3-hour algorithm

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Composite of all-cause mortality or new AMI (type 1) occurring within 30 days of index presentation
Time Frame: 30 days
Mortality rate and number of newly diagnosed AMI (type 1) in all enrolled patients
30 days
Time from ED presentation to ED discharge or transfer
Time Frame: 30 days
Length of stay in the ED measured in hours
30 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of patients managed as outpatients
Time Frame: 24 hours
Number of patients who stay in hospital for index event less than 24 hours
24 hours
Readmission for suspected AMI within 30 days after index presentation
Time Frame: 30 days
Number of patients who stay in hospital for a new suspected AMI more than 24 hours within 30 days of index presentation
30 days
All-cause mortality at 30 days in all patients
Time Frame: 30 days
Number of deceased patients within 30 days after index presentation
30 days
All-cause mortality at 365 days in all patients
Time Frame: 365 days
Number of deceased patients within 365 days after index presentation
365 days
New AMI (type1) at 30 days in all patients
Time Frame: 30 days
Number of newly diagnosed AMI (type 1) in all patients within 30 days of index presentation
30 days
New AMI (type 1) at 365 days in all patients
Time Frame: 365 days
Number of newly diagnosed AMI (type 1) in all patients within 365 days of index presentation
365 days
Composite of all-cause mortality or new AMI (type 1) at 365 days after index presentation
Time Frame: 365 days
Mortality rate and number of newly diagnosed AMI (type 1) in all enrolled patients
365 days
Satisfaction of patients with their evaluation in the ED
Time Frame: 30 days
Satisfaction will be measured on a numerical/visual analogue scale from 0-100%, the higher the score, the greater the satisfaction
30 days
Treatment costs in the ED
Time Frame: 365 days
Costs of procedures performed in the ED will be calculated according to national remuneration systems
365 days
Length of stay in the ED
Time Frame: 30 days
Length of stay from admission to the ED to discharge or transfer will be calculated according to national remuneration systems
30 days
Feasibility of the 0/1-hour algorithm
Time Frame: 80 minutes
Feasibility defined as the percentage of patients in whom the "1h" blood draw is performed within 1h +/- 20 minutes from the "0h" blood draw
80 minutes
Effectiveness of rule-in
Time Frame: 30 days
Effectiveness defined as the time from presentation to coronary angiography in patients ultimately diagnosed with AMI (type 1)
30 days
Effectiveness of rule-out
Time Frame: 30 days
Effectiveness defined as time from presentation to discharge in patients ultimately diagnosed with non-cardiac disease
30 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Hospital, Basel, Switzerland

Investigators

  • Principal Investigator: Christian Müller, MD Prof., University Hospital, Basel, Switzerland
  • Principal Investigator: Jasper Boeddinghaus, MD, University Hospital, Basel, Switzerland

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2020

Primary Completion (Estimated)

December 31, 2027

Study Completion (Estimated)

May 31, 2028

Study Registration Dates

First Submitted

November 14, 2022

First Submitted That Met QC Criteria

December 5, 2022

First Posted (Actual)

December 14, 2022

Study Record Updates

Last Update Posted (Actual)

January 27, 2026

Last Update Submitted That Met QC Criteria

January 23, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2019-02269

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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