Myocardial InfarctionAPACENCT00470587
Advantageous Predictors of Acute Coronary Syndromes Evaluation (APACE) Study
An observational study of Myocardial Infarction and Angina, Unstable, run by University Hospital, Basel, Switzerland at 13 sites in 5 countries.
Trial summary
The triage of patients with suspected acute coronary syndrome in the emergency room is a time-consuming diagnostic challenge. Therefore high sensitive early markers for myocardial damage are needed for more rapidly rule out of acute myocardial infarction (AMI) - especially for the first 3 to 4 hours after onset of… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Myocardial Infarction, Angina, Unstable
- How many people
- 10,000 participants
- Where
- 13 sitesin 5 countries
- Study dates
- Apr 2006to Dec 2025
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients presenting to the emergency department with typical angina pectoris or other thoracic sensations at rest or minor exertion that are suspected to be caused by myocardial ischemia. Onset of symptoms within the last 12 hours prior to presentation.
Who may be able to join
- Patients presenting to the emergency department
- Typical angina pectoris or other thoracic sensations that are suspected to be caused by myocardial ischemia
- Symptoms at rest or minor exertion
- Onset of symptoms within the last 12 hours prior to presentation
- Written informed consent
Who cannot join
- Age < 18 years
- Cardiogenic shock
- Terminal kidney disease requiring regular dialysis
Trial locations and contacts
13 sites in 5 countries.
13 sites in 5 countries
Switzerland7 sites
University Hospital of Basel
Basel, 4031
Kantonsspital Baselland, Standort Bruderholz
Bottmingen
Kantonsspital Baselland, Standort Liestal
Liestal
Klinik St. Anna
Lucerne
Kantonsspital Olten
Olten
Spital Limmattal
Schlieren
Universitätsspital Zürich
Zurich
Spain3 sites
Hospital Clinic of Barcelona
Barcelona, 08036
Hospital del Mar
Barcelona
Hospital Clinico San Carlos
Madrid
About this study
The triage of patients with suspected acute coronary syndrome in the emergency room is a time-consuming diagnostic challenge. Therefore high sensitive early markers for myocardial damage are needed for more rapidly rule out of acute myocardial infarction (AMI) - especially for the first 3 to 4 hours after onset of chest pain in AMI ("troponin-blind" period).
Therefore we test the hypothesis that the use meticulous patient history and novel cardiac markers can provide a faster detection or exclusion of AMI in patients presenting with acute chest pain to the emergency department.
The prospective cohort study is designed to enrol patients presenting with acute chest pain at rest within the last 12 hours to the emergency department. Several blood samples for detection of the new markers will be drawn and compared with the gold standard for the diagnosis of AMI (high-sensitivity cardiac troponin T). All patients will be contacted by telephone at 3, 12, 24 and 60 months to determine functional status, major adverse cardiac events (death, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention), and the results of cardiac examination (stress test, coronary angiography) if performed.
Read the detailed description
Background: The triage of patients with suspected acute coronary syndrome in the emergency room is a time-consuming diagnostic challenge. Triage and management of patients with low probability of coronary artery disease often cause excessive hospital costs. Therefore high sensitive early markers for myocardial damage are needed for more rapidly rule out of acute myocardial infarction (AMI).
Cardiac troponins (T and I) are currently the gold standard for definitive AMI diagnosis due to their high sensitivity and specificity for detection of myocardial cell injury. Unfortunately, troponin is undetectable by current assays in peripheral blood within 3 to 4 hours after onset of chest pain in AMI ("troponin-blind" period).
New cardiac markers such as the novel high-sensitive troponin I/T, ischemia modified albumin and placental growth factor have demonstrated certain advantages compared to troponin such as high negative predictive value for AMI, earlier verifiability in peripheral blood and possible value as independent risk marker. However, clinical evaluation in a large cohort of unselected patients presenting to an emergency department is still lacking.
Aim: To test the hypothesis that the use meticulous patient history and novel cardiac markers (including high-sensitive troponin I/T, myeloperoxidase, ischemia modified albumin, placental growth factor) can provide a faster detection or exclusion of AMI in patients presenting with acute chest pain to the emergency department.
Patients and Methods: The prospective cohort study is designed to enrol unselected patients presenting with acute chest pain at rest within the last 12 hours to the emergency department. Several blood samples for detection of the new markers will be drawn (baseline, 1, 2, 3 and 6 hours) and compared with the gold standard for the diagnosis of AMI (high-sensitivity cardiac troponin T). Timing and treatment of patients are left to the discretion of the attending physician and will be performed according to the standard house routine of the hospital. All patients will be contacted by telephone at 6, 12, 24 and 60 months to determine functional status, major adverse cardiac events (death, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention), and the results of cardiac examination (stress test, coronary angiography) if performed.
Expected results: It is our hypothesis that the use meticulous patient history and novel cardiac markers can improve the detection of AMI by providing an early diagnosis for AMI with a high negative predictive value within the "troponin-blind" period.
Significance: The earlier detection of myocardial necrosis in peripheral blood could help to rule out AMI more rapidly. In addition it will allow a more rapid diagnosis and appropriate therapy of AMI. This can lead to a significant improvement in patient management and a reduction of in-hospital costs.
- Conditions
- Myocardial Infarction, Angina, Unstable
- Keywords
- chest pain, myocardial infarction, unstable angina
- Medical subject headings
- Myocardial Infarction, Angina, Unstable, Chest Pain
What is being measured
The primary outcome is the main question the study is designed to answer.
Diagnostic utility of various biomarkers, detailed patient's history and examination as well as ECG findings for the early diagnosis of acute myocardial infarction
Measured: at admission
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 May 2007 (estimated)
- Study startApr 2006
- Primary completion2 Mar 2025
- Study completionDec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (85)Papers the sponsor has linked to this study.
- Other trials for Myocardial InfarctionStudies of the same condition, open and under way.
- More trials run by University Hospital, Basel, SwitzerlandThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 10,000 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospital, Basel, Switzerland
- Sponsor type
- University, hospital or other
- Collaborators
- Swiss National Science Foundation
- Responsible party
- Sponsor
- Investigators
- Christian Mueller, MD, Principal investigator, University Hospital of Basel
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00470587
- Sponsor's protocol ID
- APACE
- Acronym
- APACE
- Status last verified
- Dec 2025
- First submitted
- 7 May 2007
- Last updated
- 15 Dec 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Odermatt R, Koechlin L, Lopez-Ayala P, Kaplan E, Recuenco LH, Hure G, Bima P, Crisanti L, Wildi K, Miro O, Christ M, Keller DI, Martin-Sanchez JF, Morawiec B, Geigy N, Mahfoud F, Biefer HRC, Dzemali O, Boeddinghaus J, Strebel I, Mueller C; APACE Investigators. Cardiac Myosin-Binding Protein C for Diagnosis of Myocardial Infarction in Patients With Prior Coronary Artery Bypass Grafting. J Am Heart Assoc. 2026 Oct 10:e049244. doi: 10.1161/JAHA.126.049244. Online ahead of print.
PubMed 42858040Koechlin L, Boeddinghaus J, Lopez-Ayala P, Jacobsen G, McCord J, Heimbach B, Nestelberger T, Wildi K, Kaplan E, Gualandro DM, Hure G, Miro O, Christ M, Martin-Sanchez FJ, Rodriguez Cetina Biefer H, Dzemali O, Mahfoud F, Mueller C; APACE investigators. Direct Comparison of the 0/1h- and 0/2h-Algorithms in Patients With Prior Coronary Artery Bypass Grafting. J Am Heart Assoc. 2026 Aug 20:e046718. doi: 10.1161/JAHA.125.046718. Online ahead of print.
PubMed 42622139Champetier A, Lopez-Ayala P, Reich C, Boeddinghaus J, Cattin P, Koechlin L, Miro O, Christ M, Keller DI, Martin-Sanchez FJ, Morawiec B, Parenica J, Kaplan E, Bima P, Recuenco LH, Hure G, Herzka D, Wildi K, Crisanti L, Durak K, Schaffer JS, Zimmermann T, Mahfoud F, Lindahl B, Giannitsis E, Strebel I, Mueller C; APACE; TRAPID-AMI Investigatorsn; TRAPID-AMI Investigators. Machine learning for diagnosing non-ST-segment elevation myocardial infarction: a derivation and validation study. EClinicalMedicine. 2026 Jul 9;97:104055. doi: 10.1016/j.eclinm.2026.104055. eCollection 2026 Jul.
PubMed 42473534Durak K, Lopez-Ayala P, Koechlin L, Boeddinghaus J, De Vita F, Kaplan E, Herraiz-Recuenco L, Miro O, Christ M, Keller DI, Martin-Sanchez JF, Morawiec B, Parenica J, Hure G, Dinkel O, Wildi K, Bima P, Glaeser J, Spagnuolo C, Mahfoud F, Strebel I, Mueller C; APACE investigators. Alternative Rule-Out Cutoffs for a Novel High-Sensitivity Cardiac Troponin I Assay in Patients With Suspected Myocardial Infarction. J Am Heart Assoc. 2026 Apr 21;15(8):e045517. doi: 10.1161/JAHA.125.045517. Epub 2026 Apr 16.
PubMed 41988955Koechlin L, Lopez-Ayala P, Thurston AJF, Tew YY, O'Brien R, Gray A, Bima P, Kaplan E, Miro O, Christ M, Keller DI, Martin-Sanchez JF, Morawiec B, Parenica J, Herraiz Recuenco L, Hure G, Wildi K, Crisanti L, Spagnuolo C, Glaeser J, Caubergh C, Rentsch K, Slankamenac K, Rodriguez Cetina Biefer H, Dzemali O, Strebel I, Mahfoud F, Mills NL, Boeddinghaus J, Mueller C; APACE and POC-ET Investigators. High-Sensitivity Cardiac Troponin T-gen6 Assay in Suspected Myocardial Infarction: Diagnostic Accuracy, Cutoffs, and Clinical Implications. J Am Coll Cardiol. 2026 May 5;87(17):2236-2257. doi: 10.1016/j.jacc.2025.12.052. Epub 2026 Mar 25.
PubMed 41879583Lopez-Ayala P, Boeddinghaus J, Koechlin L, Bima P, Glaeser J, Spagnuolo CC, Crisanti L, Miro O, Martin-Sanchez FJ, Christ M, Wildi K, Piazza S, Nestelberger T, Gimenez MR, Gehrke J, Formambuh J, Kaplan E, Hure G, Breidthardt T, Giannitsis E, Lindahl B, Marber M, Mahfoud F, Strebel I, Mueller C; APACE and TRAPID-AMI investigators. Incremental Value of Cardiac Myosin-Binding Protein C for the Early Diagnosis of Acute Myocardial Infarction. J Am Coll Cardiol. 2025 Dec 23;86(25):2616-2632. doi: 10.1016/j.jacc.2025.09.008. Epub 2025 Nov 12.
PubMed 41222525Dugar F, Lopez-Ayala P, Koechlin L, Bima P, Glaeser J, Spagnuolo C, Crisanti L, Wick C, Wildi K, Kaplan E, Strebel I, Miro O, Martin-Sanchez FJ, Christ M, Morawiec B, Gimenez MR, Nestelberger T, Boeddinghaus J, Mueller C; APACE investigators. Diagnostic and prognostic utility of endocan in suspected myocardial infarction: an international cohort study. Clin Chim Acta. 2026 Jan 1;578:120510. doi: 10.1016/j.cca.2025.120510. Epub 2025 Jul 25.
PubMed 40716696Wildi K, Gimenez MR, Boeddinghaus J, Nestelberger T, Lopez-Ayala P, Koechlin L, Gerstenberger M, Carter N, Bima P, Glaeser J, Spagnuolo C, Miro O, Martin-Sanchez FJ, Christ M, Keller DI, Gualandro DM, Kawecki D, Rentsch K, Mahfoud F, Mueller C; APACE Investigators dagger. Possible Misdiagnosis of Myocardial Infarction Using Regulatory-Approved and Close-to-Bioequivalent Upper Limits of Normal for Cardiac Troponin. J Am Heart Assoc. 2025 May 20;14(10):e040468. doi: 10.1161/JAHA.124.040468. Epub 2025 May 13.
PubMed 40357766Koechlin L, Boeddinghaus J, Lopez-Ayala P, Reber C, Nestelberger T, Wildi K, Spagnuolo CC, Strebel I, Glaeser J, Bima P, Crisanti L, Herraiz-Recuenco L, Dubach E, Miro O, Martin-Sanchez FJ, Kawecki D, Keller DI, Christ M, Buser A, Gimenez MR, Storvold GL, Broughton MN, Omland T, Lyngbakken MN, Rosjo H, Mueller C; APACE Investigators. Clinical and Analytical Performance of a Novel Point-of-Care High-Sensitivity Cardiac Troponin I Assay. J Am Coll Cardiol. 2024 Aug 20;84(8):726-740. doi: 10.1016/j.jacc.2024.05.056.
PubMed 39142727Albus M, Zimmermann T, Median D, Rumora K, Isayeva G, Amrein M, Schaefer I, Walter J, Michel E, Hure G, Strebel I, Caobelli F, Haaf P, Frey SM, Mueller C, Zellweger MJ. Combining anatomical and biochemical markers in the detection and risk stratification of coronary artery disease. Eur Heart J Cardiovasc Imaging. 2024 Aug 26;25(9):1197-1205. doi: 10.1093/ehjci/jeae093.
PubMed 38591997Boeddinghaus J, Doudesis D, Lopez-Ayala P, Lee KK, Koechlin L, Wildi K, Nestelberger T, Borer R, Miro O, Martin-Sanchez FJ, Strebel I, Rubini Gimenez M, Keller DI, Christ M, Bularga A, Li Z, Ferry AV, Tuck C, Anand A, Gray A, Mills NL, Mueller C; CoDE-ACS and APACE Investigators. Machine Learning for Myocardial Infarction Compared With Guideline-Recommended Diagnostic Pathways. Circulation. 2024 Apr 2;149(14):1090-1101. doi: 10.1161/CIRCULATIONAHA.123.066917. Epub 2024 Feb 12.
PubMed 38344871Koechlin L, Boeddinghaus J, Lopez-Ayala P, Wildi K, Nestelberger T, Wussler D, Guzman Tacla CA, Holder T, Muench-Gerber T, Glaeser J, Sanchez AY, Miro O, Martin-Sanchez FJ, Kawecki D, Buergler F, Buser A, Hure G, Gimenez MR, Keller DI, Christ M, Mueller C; APACE investigators. External validation of the 0/1h-algorithm and derivation of a 0/2h-algorithm using a new point-of-care Hs-cTnI assay. Am Heart J. 2024 Feb;268:104-113. doi: 10.1016/j.ahj.2023.11.014. Epub 2023 Dec 1.
PubMed 38042459Bima P, Lopez-Ayala P, Koechlin L, Boeddinghaus J, Nestelberger T, Okamura B, Muench-Gerber TS, Sanzone A, Skolozubova D, Djurdjevic D, Rubini Gimenez M, Wildi K, Miro O, Martinez-Nadal G, Martin-Sanchez FJ, Christ M, Keller D, Lindahl B, Giannitsis E, Mueller C; APACE and TRAPID-AMI Investigators. Chest Pain in Cancer Patients: Prevalence of Myocardial Infarction and Performance of High-Sensitivity Cardiac Troponins. JACC CardioOncol. 2023 Aug 26;5(5):591-609. doi: 10.1016/j.jaccao.2023.08.001. eCollection 2023 Oct.
PubMed 37969646Yufera-Sanchez A, Lopez-Ayala P, Nestelberger T, Wildi K, Boeddinghaus J, Koechlin L, Rubini Gimenez M, Sakiz H, Bima P, Miro O, Martin-Sanchez FJ, Christ M, Keller DI, Gualandro DM, Kawecki D, Rentsch K, Buser A, Mueller C; APACE Investigators. Combining glucose and high-sensitivity cardiac troponin in the early diagnosis of acute myocardial infarction. Sci Rep. 2023 Sep 5;13(1):14598. doi: 10.1038/s41598-023-37093-1.
PubMed 37670005Fernandez-Cisnal A, Lopez-Ayala P, Valero E, Koechlin L, Catarrala A, Boeddinghaus J, Noceda J, Nestelberger T, Miro O, Julio N, Mueller C, Sanchis J. Derivation and external validation of machine-learning models for risk stratification in chest pain with normal troponin. Eur Heart J Acute Cardiovasc Care. 2023 Nov 16;12(11):743-752. doi: 10.1093/ehjacc/zuad089.
PubMed 37531633
Study at a glance
From the registry record, last updated by the sponsor on 15 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Advantageous Predictors of Acute Coronary Syndromes Evaluation (APACE) Study
- ClinicalTrials.gov ID
- NCT00470587
- Acronym / sponsor ID
- APACE / APACE
- Conditions
- Myocardial Infarction, Angina, Unstable
- Keywords
- chest pain, myocardial infarction, unstable angina
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 10,000 participants (actual)
- Lead sponsor
- University Hospital, Basel, SwitzerlandUniversity, hospital or other
- Collaborators
- Swiss National Science Foundation
- Study start
- Apr 2006
- Primary completion
- 2 Mar 2025 (actual)
- Study completion
- Dec 2025 (actual)
- First posted
- 8 May 2007 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The triage of patients with suspected acute coronary syndrome in the emergency room is a time-consuming diagnostic challenge. Therefore high sensitive early markers for myocardial damage are needed for more rapidly rule out of acute myocardial infarction (AMI) - especially for the first 3 to 4 hours after onset of chest pain in AMI ("troponin-blind" period).
Therefore we test the hypothesis that the use meticulous patient history and novel cardiac markers can provide a faster detection or exclusion of AMI in patients presenting with acute chest pain to the emergency department.
The prospective cohort study is designed to enrol patients presenting with acute chest pain at rest within the last 12 hours to the emergency department. Several blood samples for detection of the new markers will be drawn and compared with the gold standard for the diagnosis of AMI (high-sensitivity cardiac troponin T). All patients will be contacted by telephone at 3, 12, 24 and 60 months to determine functional status, major adverse cardiac events (death, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention), and the results of cardiac examination (stress test, coronary angiography) if performed.
Detailed description
Background: The triage of patients with suspected acute coronary syndrome in the emergency room is a time-consuming diagnostic challenge. Triage and management of patients with low probability of coronary artery disease often cause excessive hospital costs. Therefore high sensitive early markers for myocardial damage are needed for more rapidly rule out of acute myocardial infarction (AMI).
Cardiac troponins (T and I) are currently the gold standard for definitive AMI diagnosis due to their high sensitivity and specificity for detection of myocardial cell injury. Unfortunately, troponin is undetectable by current assays in peripheral blood within 3 to 4 hours after onset of chest pain in AMI ("troponin-blind" period).
New cardiac markers such as the novel high-sensitive troponin I/T, ischemia modified albumin and placental growth factor have demonstrated certain advantages compared to troponin such as high negative predictive value for AMI, earlier verifiability in peripheral blood and possible value as independent risk marker. However, clinical evaluation in a large cohort of unselected patients presenting to an emergency department is still lacking.
Aim: To test the hypothesis that the use meticulous patient history and novel cardiac markers (including high-sensitive troponin I/T, myeloperoxidase, ischemia modified albumin, placental growth factor) can provide a faster detection or exclusion of AMI in patients presenting with acute chest pain to the emergency department.
Patients and Methods: The prospective cohort study is designed to enrol unselected patients presenting with acute chest pain at rest within the last 12 hours to the emergency department. Several blood samples for detection of the new markers will be drawn (baseline, 1, 2, 3 and 6 hours) and compared with the gold standard for the diagnosis of AMI (high-sensitivity cardiac troponin T). Timing and treatment of patients are left to the discretion of the attending physician and will be performed according to the standard house routine of the hospital. All patients will be contacted by telephone at 6, 12, 24 and 60 months to determine functional status, major adverse cardiac events (death, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention), and the results of cardiac examination (stress test, coronary angiography) if performed.
Expected results: It is our hypothesis that the use meticulous patient history and novel cardiac markers can improve the detection of AMI by providing an early diagnosis for AMI with a high negative predictive value within the "troponin-blind" period.
Significance: The earlier detection of myocardial necrosis in peripheral blood could help to rule out AMI more rapidly. In addition it will allow a more rapid diagnosis and appropriate therapy of AMI. This can lead to a significant improvement in patient management and a reduction of in-hospital costs.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients presenting to the emergency department with typical angina pectoris or other thoracic sensations at rest or minor exertion that are suspected to be caused by myocardial ischemia. Onset of symptoms within the last 12 hours prior to presentation.
Key inclusion criteria (5 listed)
- Patients presenting to the emergency department
- Typical angina pectoris or other thoracic sensations that are suspected to be caused by myocardial ischemia
- Symptoms at rest or minor exertion
- Onset of symptoms within the last 12 hours prior to presentation
- Written informed consent
Key exclusion criteria (3 listed)
- Age < 18 years
- Cardiogenic shock
- Terminal kidney disease requiring regular dialysis
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Diagnostic utility of various biomarkers, detailed patient's history and examination as well as ECG findings for the early diagnosis of acute myocardial infarction
Time frame: at admission
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Dec 2025.
- Derived from this study: PubMed 42858040Odermatt R, Koechlin L, Lopez-Ayala P, Kaplan E, Recuenco LH, Hure G, Bima P, Crisanti L, Wildi K, Miro O, Christ M, Keller DI, Martin-Sanchez JF, Morawiec B, Geigy N, Mahfoud F, Biefer HRC, Dzemali O, Boeddinghaus J, Strebel I, Mueller C; APACE Investigators. Cardiac Myosin-Binding Protein C for Diagnosis of Myocardial Infarction in Patients With Prior Coronary Artery Bypass Grafting. J Am Heart Assoc. 2026 Oct 10:e049244. doi: 10.1161/JAHA.126.049244. Online ahead of print.
- Derived from this study: PubMed 42622139Koechlin L, Boeddinghaus J, Lopez-Ayala P, Jacobsen G, McCord J, Heimbach B, Nestelberger T, Wildi K, Kaplan E, Gualandro DM, Hure G, Miro O, Christ M, Martin-Sanchez FJ, Rodriguez Cetina Biefer H, Dzemali O, Mahfoud F, Mueller C; APACE investigators. Direct Comparison of the 0/1h- and 0/2h-Algorithms in Patients With Prior Coronary Artery Bypass Grafting. J Am Heart Assoc. 2026 Aug 20:e046718. doi: 10.1161/JAHA.125.046718. Online ahead of print.
- Derived from this study: PubMed 42473534Champetier A, Lopez-Ayala P, Reich C, Boeddinghaus J, Cattin P, Koechlin L, Miro O, Christ M, Keller DI, Martin-Sanchez FJ, Morawiec B, Parenica J, Kaplan E, Bima P, Recuenco LH, Hure G, Herzka D, Wildi K, Crisanti L, Durak K, Schaffer JS, Zimmermann T, Mahfoud F, Lindahl B, Giannitsis E, Strebel I, Mueller C; APACE; TRAPID-AMI Investigatorsn; TRAPID-AMI Investigators. Machine learning for diagnosing non-ST-segment elevation myocardial infarction: a derivation and validation study. EClinicalMedicine. 2026 Jul 9;97:104055. doi: 10.1016/j.eclinm.2026.104055. eCollection 2026 Jul.
- Derived from this study: PubMed 41988955Durak K, Lopez-Ayala P, Koechlin L, Boeddinghaus J, De Vita F, Kaplan E, Herraiz-Recuenco L, Miro O, Christ M, Keller DI, Martin-Sanchez JF, Morawiec B, Parenica J, Hure G, Dinkel O, Wildi K, Bima P, Glaeser J, Spagnuolo C, Mahfoud F, Strebel I, Mueller C; APACE investigators. Alternative Rule-Out Cutoffs for a Novel High-Sensitivity Cardiac Troponin I Assay in Patients With Suspected Myocardial Infarction. J Am Heart Assoc. 2026 Apr 21;15(8):e045517. doi: 10.1161/JAHA.125.045517. Epub 2026 Apr 16.
- Derived from this study: PubMed 41879583Koechlin L, Lopez-Ayala P, Thurston AJF, Tew YY, O'Brien R, Gray A, Bima P, Kaplan E, Miro O, Christ M, Keller DI, Martin-Sanchez JF, Morawiec B, Parenica J, Herraiz Recuenco L, Hure G, Wildi K, Crisanti L, Spagnuolo C, Glaeser J, Caubergh C, Rentsch K, Slankamenac K, Rodriguez Cetina Biefer H, Dzemali O, Strebel I, Mahfoud F, Mills NL, Boeddinghaus J, Mueller C; APACE and POC-ET Investigators. High-Sensitivity Cardiac Troponin T-gen6 Assay in Suspected Myocardial Infarction: Diagnostic Accuracy, Cutoffs, and Clinical Implications. J Am Coll Cardiol. 2026 May 5;87(17):2236-2257. doi: 10.1016/j.jacc.2025.12.052. Epub 2026 Mar 25.
- Derived from this study: PubMed 41222525Lopez-Ayala P, Boeddinghaus J, Koechlin L, Bima P, Glaeser J, Spagnuolo CC, Crisanti L, Miro O, Martin-Sanchez FJ, Christ M, Wildi K, Piazza S, Nestelberger T, Gimenez MR, Gehrke J, Formambuh J, Kaplan E, Hure G, Breidthardt T, Giannitsis E, Lindahl B, Marber M, Mahfoud F, Strebel I, Mueller C; APACE and TRAPID-AMI investigators. Incremental Value of Cardiac Myosin-Binding Protein C for the Early Diagnosis of Acute Myocardial Infarction. J Am Coll Cardiol. 2025 Dec 23;86(25):2616-2632. doi: 10.1016/j.jacc.2025.09.008. Epub 2025 Nov 12.
- Derived from this study: PubMed 40716696Dugar F, Lopez-Ayala P, Koechlin L, Bima P, Glaeser J, Spagnuolo C, Crisanti L, Wick C, Wildi K, Kaplan E, Strebel I, Miro O, Martin-Sanchez FJ, Christ M, Morawiec B, Gimenez MR, Nestelberger T, Boeddinghaus J, Mueller C; APACE investigators. Diagnostic and prognostic utility of endocan in suspected myocardial infarction: an international cohort study. Clin Chim Acta. 2026 Jan 1;578:120510. doi: 10.1016/j.cca.2025.120510. Epub 2025 Jul 25.
- Derived from this study: PubMed 40357766Wildi K, Gimenez MR, Boeddinghaus J, Nestelberger T, Lopez-Ayala P, Koechlin L, Gerstenberger M, Carter N, Bima P, Glaeser J, Spagnuolo C, Miro O, Martin-Sanchez FJ, Christ M, Keller DI, Gualandro DM, Kawecki D, Rentsch K, Mahfoud F, Mueller C; APACE Investigators dagger. Possible Misdiagnosis of Myocardial Infarction Using Regulatory-Approved and Close-to-Bioequivalent Upper Limits of Normal for Cardiac Troponin. J Am Heart Assoc. 2025 May 20;14(10):e040468. doi: 10.1161/JAHA.124.040468. Epub 2025 May 13.
- Derived from this study: PubMed 39142727Koechlin L, Boeddinghaus J, Lopez-Ayala P, Reber C, Nestelberger T, Wildi K, Spagnuolo CC, Strebel I, Glaeser J, Bima P, Crisanti L, Herraiz-Recuenco L, Dubach E, Miro O, Martin-Sanchez FJ, Kawecki D, Keller DI, Christ M, Buser A, Gimenez MR, Storvold GL, Broughton MN, Omland T, Lyngbakken MN, Rosjo H, Mueller C; APACE Investigators. Clinical and Analytical Performance of a Novel Point-of-Care High-Sensitivity Cardiac Troponin I Assay. J Am Coll Cardiol. 2024 Aug 20;84(8):726-740. doi: 10.1016/j.jacc.2024.05.056.
- Derived from this study: PubMed 38591997Albus M, Zimmermann T, Median D, Rumora K, Isayeva G, Amrein M, Schaefer I, Walter J, Michel E, Hure G, Strebel I, Caobelli F, Haaf P, Frey SM, Mueller C, Zellweger MJ. Combining anatomical and biochemical markers in the detection and risk stratification of coronary artery disease. Eur Heart J Cardiovasc Imaging. 2024 Aug 26;25(9):1197-1205. doi: 10.1093/ehjci/jeae093.
- Derived from this study: PubMed 38344871Boeddinghaus J, Doudesis D, Lopez-Ayala P, Lee KK, Koechlin L, Wildi K, Nestelberger T, Borer R, Miro O, Martin-Sanchez FJ, Strebel I, Rubini Gimenez M, Keller DI, Christ M, Bularga A, Li Z, Ferry AV, Tuck C, Anand A, Gray A, Mills NL, Mueller C; CoDE-ACS and APACE Investigators. Machine Learning for Myocardial Infarction Compared With Guideline-Recommended Diagnostic Pathways. Circulation. 2024 Apr 2;149(14):1090-1101. doi: 10.1161/CIRCULATIONAHA.123.066917. Epub 2024 Feb 12.
- Derived from this study: PubMed 38042459Koechlin L, Boeddinghaus J, Lopez-Ayala P, Wildi K, Nestelberger T, Wussler D, Guzman Tacla CA, Holder T, Muench-Gerber T, Glaeser J, Sanchez AY, Miro O, Martin-Sanchez FJ, Kawecki D, Buergler F, Buser A, Hure G, Gimenez MR, Keller DI, Christ M, Mueller C; APACE investigators. External validation of the 0/1h-algorithm and derivation of a 0/2h-algorithm using a new point-of-care Hs-cTnI assay. Am Heart J. 2024 Feb;268:104-113. doi: 10.1016/j.ahj.2023.11.014. Epub 2023 Dec 1.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Christian Mueller, MD principal investigator
University Hospital of Basel
13 sites in 5 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Myocardial Infarction and Angina, Unstable, run by University Hospital, Basel, Switzerland at 13 sites in 5 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 13 sites in Switzerland, Spain, Czechia, Italy, Poland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Diagnostic utility of various biomarkers, detailed patient's history and examination as well as ECG findings for the early diagnosis of acute myocardial infarction (time frame: at admission). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00470587, which also lists 85 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Dec 2025.