Diagnostic performance of cardiac Troponin I for early rule-in and rule-out of acute myocardial infarction: Results of a prospective multicenter trial.

•We compare TnI serial intervals and determine optimal diagnostic thresholds for MI.•Prospective multicenter adjudicated trial, 14 emergency departments, 1929 patients.•AccuTnI+3 ≥0.03ng/mL provided high diagnostic sensitivity (≥95%) at 1–3h and 3–6h.•NPV (rule-out, non-MI) was nearly 100% at 1–3h and 3–6h.•As TnI values rise, probability of MI increases. Values ≥0.20ng/mL=~90% probability.