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Cohort study
Highly-sensitive troponin T algorithm facilitates early discharge of low-risk chest pain patients within 1 h of emergency department arrival
  1. Andrew D McRae,
  2. James E Andruchow
  1. Emergency Medicine, University of Calgary, Calgary, Alberta, Canada
  1. Correspondence to: Dr Andrew D McRae, Emergency Medicine, University of Calgary, Rm C231, Foothills Medical Centre, 1403 29 Street NW, Calgary, Alberta, Canada T2N 2T9; amcrae{at}ucalgary.ca

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Context

A large proportion of emergency department (ED) visits involve patients with symptoms of suspected acute coronary syndrome (ACS), although ACS within this population is relatively infrequent.1 Evaluation of suspected ACS includes serial ECG and biomarker testing over several hours and frequently involves admission for provocative or invasive cardiac testing.2 Strategies to rapidly identify and safely discharge low-risk patients are important to improve resource utilisation.

Methods

This prospective cohort study of consecutive ED patients with suspected ACS was designed to validate a previously-derived3 1 h accelerated diagnostic algorithm for acute myocardial infarction (AMI) using a high-sensitivity cardiac troponin-T (hs-cTnT) assay. Patients underwent routine …

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