The original ADAPT trial prospectively validated the accelerated diagnostic protocol in 1,975 adults at two Australasian emergency departments (Brisbane and Christchurch) with ≥5 minutes of symptoms consistent with possible acute coronary syndrome (ACS) and planned serial troponin testing.

Group (ADAPT)	Proportion of cohort	30-day MACE
ADP-negative (TIMI 0, non-ischaemic ECG, negative 0/2-hour cTnI)	20% (392/1,975)	0.25% (1/392)
ADP-positive (any component positive)	80% (1,583/1,975)	≈19% 30-day MACE

Low-risk definition (original ADAPT): TIMI UA/NSTEMI risk score 0 at presentation, no new ischaemic changes on the initial ECG, and central laboratory cardiac troponin I below the institutional decision limit at both 0 and 2 hours.
The primary endpoint was 30-day major adverse cardiac events (MACE), including non-STEMI, STEMI, emergency revascularisation, cardiovascular death, serious ventricular arrhythmia or cardiac arrest, cardiogenic shock and high-grade atrioventricular block.
A high-sensitivity troponin validation study evaluated similar 0/2-hour pathways using high-sensitivity troponin I with TIMI 0 or ≤1 and ECG findings, identifying around 20–40% of patients as low risk with 0–0.8% 30-day MACE in validation cohorts.
Australian ACS guidelines describe ADAPT and modified ADAPT (TIMI 0–1 with sensitive or high-sensitivity troponin) as example Suspected ACS Assessment Protocols targeting <1% 30-day MACE in the low-risk group.
This calculator implements the original ADAPT low-risk definition (TIMI 0 only). As an accelerated diagnostic protocol rather than a personalised risk model, performance will vary with local ACS prevalence, troponin assay characteristics, sampling times and access to timely non-invasive testing and follow-up.

ADAPT Protocol for Cardiac Event Risk