AMI/Death for modified HEART score ≤ 3 and ≥ 4

Supplemental Digital Content Table 1: AMI/Death for modified HEART score ≤ 3 and ≥ 4 using different hs-cTnT cut-points (14 ng/L) over various time intervals

hs-cTnT (ng/L) < various cut- points over different time intervals

Death/AMI n (%) within 30 days Comparison P-value

HS ≥ 4 HS ≤ 3

99^th% (14) 0 hour 19/314 (6.1%) 5/530 (0.9%) <0.001 0-2 hours 8/274 (2.9%) 2/483 (0.4%) 0.006 0 – (4-14) hours 5/248 (2.0%) 1/413 (0.2%) 0.030 2X (28) 0 hour 62/467 (13.3%) 19/561 (3.4%) <0.001 0-2 hours 28/407 (6.9%) 12/511 (2.3%) <0.001 0 – (4-14) hours 21/373 (5.6%) 8/442 (1.8%) 0.003 3X (42) 0 hour 86/516 (16.7%) 28/573 (4.9%) <0.001 0-2 hours 56/455 (12.3%) 16/518 (3.1%) <0.001 0 – (4-14) hours 43/421 (10.2%) 14/452 (3.1%) <0.001 4X (56) 0 hour 83/526 (15.8%) 28/575 (4.9%) <0.001

0-2 hours 66/479 (13.8%) 18/522 (3.4%) <0.001 0 – (4-14) hours 55/441 (12.5%) 14/453 (3.1%) <0.001 5X (70) 0 hour 98/545 (18.0%) 39/587 (6.6%) <0.001

0-2 hours 72/488 (14.8%) 23/528 (4.4%) <0.001 0 – (4-14) hours 66/459 (14.4%) 15/456 (3.3%) <0.001 6X (84) 0 hour 105/554 (19.0%) 45/594 (7.6%) <0.001 0-2 hours 78/ 496(15.7%) 26/532 (4.9%) <0.001 0 – (4-14) hours 71/ 466(15.2%) 17/459 (3.7%) <0.001 7X (98) 0 hour 110/559 (19.7%) 46/595 (7.7%) <0.001

0-2 hours 88/506 (17.4%) 27/533 (5.1%) <0.001 0 – (4-14) hours 74/469 (15.8%) 19/462 (4.1%) <0.001 8X (112) 0 hour 115/564 (20.4%) 46/595 (7.7%) <0.001

0-2 hours 93/511 (18.2%) 29/535 (5.4%) <0.001 0 – (4-14) hours 79/474 (16.7%) 21/464 (4.5%) <0.001 9X (126) 0 hour 119/569 (20.9%) 46/596 (7.7%) <0.001

0-2 hours 95/514 (18.5%) 32/538 (5.9%) <0.001 0 – (4-14) hours 81/477 (17.0%) 23/466 (4.9%) <0.001 10X (140) 0 hour 120/570 (21.1%) 46/596 (7.7%) <0.001 0-2 hours 97/516 (18.8%) 32/538 (5.9%) <0.001 0 – (4-14) hours 81/477 (17.0%) 24/467 (5.1%) <0.001 99^th%, 99^th percentile; AMI, acute myocardial infarction; HS, HEART score; hs-cTnT, high-sensitivity cardiac troponin T.

Statistically significant, P < 0.05

Supplemental Digital Content Table 2: Net Reclassification Improvement (NRI) for Various hs-cTnT Cut-Points within the 0 - (4-14) Hour Setting

hs-cTnT Cut-Point for the 0 - (4-14) Hour Setting NRI Value

190 ng/L ---

171 ng/L -0.004

152 ng/L 0.004

133 ng/L -0.004

114 ng/L 0.007

95 ng/L 0.021

76 ng/L 0.037

57 ng/L 0.031

38 ng/L 0.007

19 ng/L 0.037