Background: This is a multi-center, prospective, stepped-wedge cluster randomised controlled trial. The aim is a clinical implementation of the European Society of Cardiology 0/1h-algorithm and the evaluation of its safety and efficacy for diagnosis of myocardial infarction compared to current practice. Trial Registration No: Sponsor: University Hospital Basel Trial Status: recruiting Enrolling Centers: Worldwide: 20 9 countries Core Study Team Basel: