Dr Christian Mueller
Cardiologist, Director of Cardiovascular Research Institute, University Hospital Basel, Switzerland

TRAPID-AMI Study: hs-TnT for Rapid Rule In/ Out of AMI


  • TRAPID-AMI study validated the APACE study findings namely the application of the 0h/1h algorithm for hs-TnT is safe and highly effective
  • Two groups of patients can be triaged from the rapid algorithm protocol-one that has benign disorders, and the second with confirmed diagnosis of AMI


The TRAPID-AMI study was designed in order to validate the initial findings from the APACE study. So the APACE study was a European multi-centre study that for the first time showed that it’s actually possible to rapidly rule-out and rule-in acute myocardial infarction, in a significant number of patients within 1 hour.

Of course this is something, or was something, completely new and had to be validated in large external validation studies, and TRAPID-AMI is one of two of them.

So TRAPID-AMI is a truly global international study, where patients have been enrolled on 3 continents. TRAPID-AMI included more than 1,200 patients and using the most stringent methodology available prospectively, validated and confirmed the initial findings of the APACE study, namely, that it’s safe and highly efficacious to apply the 1-hour algorithm using high-sensitivity cardiac Troponin T.

The 1-hour algorithm has been derived due to several studies that clearly have shown that the diagnostic information, provided by the cardiac troponin level at presentation, can be further increased by adding the absolute change that is seen from presentation to 1 hour, and by combining these two signals, the absolute level at presentation and the absolute change within 1 hour, allows in about 75% of patients to clearly separate two very distinct groups of patients.

Patients with rather benign disorders which usually start with low levels of high-sensitivity cardiac Troponin T and have no change within 1 hour. From the other group of patients, most of these will be found to have an acute myocardial infarction and they start with either, already at least moderately elevated levels of high-sensitivity cardiac Troponin T, or a relevant change occurring within the first hour.

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