High-Sensitivity Cardiac Troponin I and Clinical Risk Scores in Patients With Suspected Acute Coronary Syndrome

BACKGROUND:High-sensitivity cardiac troponin assays can help to identify patients who are at low risk of myocardial infarction in the emergency department. We aimed to determine whether the addition of clinical risk scores would improve the safety of early rule-out pathways for myocardial infarction...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2018-10, Vol.138 (16), p.1654-1665
Main Authors: Chapman, Andrew R, Hesse, Kerrick, Andrews, Jack, Ken Lee, Kuan, Anand, Atul, Shah, Anoop S V, Sandeman, Dennis, Ferry, Amy V, Jameson, Jack, Piya, Simran, Stewart, Stacey, Marshall, Lucy, Strachan, Fiona E, Gray, Alasdair, Newby, David E, Mills, Nicholas L
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - blood
Acute Coronary Syndrome - diagnosis
Acute Coronary Syndrome - mortality
Acute Coronary Syndrome - therapy
Adult
Aged
Biomarkers - blood
Decision Support Techniques
Emergency Service, Hospital
Female
Humans
Male
Middle Aged
Myocardial Infarction - blood
Myocardial Infarction - diagnosis
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Original s
Predictive Value of Tests
Prognosis
Prospective Studies
Reproducibility of Results
Risk Assessment
Risk Factors
Time Factors
Troponin I - blood
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Summary:BACKGROUND:High-sensitivity cardiac troponin assays can help to identify patients who are at low risk of myocardial infarction in the emergency department. We aimed to determine whether the addition of clinical risk scores would improve the safety of early rule-out pathways for myocardial infarction. METHODS:In 1935 patients with suspected acute coronary syndrome, we evaluated the safety and efficacy of 2 rule-out pathways alone or in conjunction with low-risk TIMI (Thrombolysis In Myocardial Infarction) (0 or 1), GRACE (Global Registry of Acute Coronary Events) (≤108), EDACS (Emergency Department Assessment of Chest Pain Score) (
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.118.036426