Multi-Markers In the Diagnosis of Acute Coronary Syndrome

This is a prospective, multi-center, observational, and sample procurement study of adult
subjects presenting to an Emergency Department (ED) in whom ACS is in the differential
diagnosis. Subjects must present to one of the participating EDs within 6 hours or less
from the time of symptom onset, and must have experienced at least 5 minutes of chest
discomfort.

Those ED patients with possible ACS who meet the inclusion/exclusion criteria will be
approached for study enrollment by trained research personnel.

The patient's diagnostic work-up and treatment will continue per the standards of the
treating institution. As indicated by their clinical presentation, it is anticipated that
all patients in this study will have an electrocardiogram (ECG) upon admission to the ED and
if the patient is found not to have an ST-elevation myocardial infarction (STEMI), objective
cardiac testing will be conducted for evidence of MI. The Principal Investigator at each
site will evaluate the results of the objective cardiac tests combined with biomarker
evidence of myocardial necrosis to determine whether or not a patient enrolled at their site
has a final diagnosis of ACS.

Cardiac events and procedure, such as angioplasty-stenting and coronary artery bypass
surgery (CABG), will be recorded during the index ED visit, hospitalization and
post-hospital follow-up period. Subjects will have a 30-day, 3 month and 6 month follow-up
contact by phone or medical chart review to collect this information on cardiac events,
procedures and survival.

Blood samples collected at several time points during the index ED visit will be used for
future testing of novel blood markers as they become available.