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  • Highly-sensitive troponin T algorithm facilitates early discharge of low-risk chest pain patients within 1 h of emergency department arrival

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Diagnosis
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

https://doi.org/10.1136/ebmed-2015-110224

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    Commentary on: Reichlin T, Twerenbold R, Wildi K, et al. Prospective validation of a 1-hour algorithm to rule-out and rule-in acute myocardial infarction using a high-sensitivity cardiac troponin T assay. CMAJ 2015;187:E243–52.OpenUrlAbstract/FREE Full Text

    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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    Footnotes

    • Twitter Follow Andrew McRae at @AMcRaeEDMD

    • Contributors ADM and JEA drafted the manuscript.

    • Competing interests ADM has received research grants from Canadian Institutes of Health Research. ADM and JEA have received research grants from Roche Diagnostics.

    • Provenance and peer review Commissioned; internally peer reviewed.