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Inclusion criteria consisted of chest pain lasting more than 5?min, regardless of age and gender, without ST-segment elevation on ECG defined by the absence of ST/T abnormalities or dynamic changes, such as nonpersistent ST-segment elevation, ST depression, T-wave abnormalities or no ECG changes. Exclusion criteria consisted of STEMI, chest pain for a duration of less than 5?min, prior hospitalization within 48?h, known autoimmune diseases such as rheumatoid arthritis (RA), systemic lupus erythematosous (SLE) or anti-phospholipid syndrome (APS), known HIV or clinically patent signs of heart failure. Between January and April 2009, 159 patients were screened at the ED of Geneva University Hospital (a primary care hospital) http://www.selleckchem.com/products/z-vad-fmk.html for acute chest pain. Twenty-one patients were excluded: eight patients with STEMI, four with RA, one with APS, five with patent signs of heart failure, one with HIV and two with chest pain for http://www.selleck.cn/products/BIBW2992.html Medical history was obtained at admission. Two predetermined endpoints were considered for this explorative study. The primary endpoint was a discharge diagnosis of NSTEMI versus chest pain related to unstable angina or to ��other diagnoses��. Chest pain aetiology was adjudicated by two senior cardiologists blinded to the participants�� biochemical data. Diagnosis of NSTEMI was established using the universal criteria of type 1 acute myocardial infarction (AMI) based on dynamic changes in cTnI levels in the appropriate clinical context [19], excluding persistent STEMI. Patients were considered to have diagnoses other than NSTEMI when cTnI values were negative, following further investigation by coronary angiography for those with a higher pretest probability of ischaemic origin or http://www.selleckchem.com/products/ly2157299.html noninvasive testing, including treadmill test, cardiac magnetic resonance imaging, stress echocardiography or myocardial perfusion scintigraphy in ambulatory settings, for patients at lowest risk. Patients with possible UA were considered as low-risk NST-ACS and were accordingly attributed to the ��other diagnoses�� group [2, 3]. If patients did not fulfil the universal criteria of AMI [19] in the presence of cTnI elevation, a nonischaemic aetiology was concluded only after exclusion of ischaemia using myocardial scintigraphy or cardiac magnetic resonance imaging, or after exclusion of a significant culprit coronary lesion by coronary angiography. The secondary endpoint was subsequent cTnI elevation (