The Manchester Acute Coronary Syndromes (MACS) decision rule for suspected cardiac chest pain: Derivation and external validation

Heart

Volumn 100, Issue 18, 2014, Pages 1462-1468

  Body, Richard ^a,b   Carley, Simon ^b,c   McDowell, Garry ^a   Pemberton, Philip ^b   Burrows, Gillian ^d   Cook, Gary ^d   Lewis, Philip S ^d   Smith, Alexander ^b   MacKway Jones, Kevin ^b,c  

^a UNIVERSITY OF MANCHESTER   (United Kingdom)

^b MANCHESTER ROYAL INFIRMARY   (United Kingdom)

^c MANCHESTER METROPOLITAN UNIVERSITY   (United Kingdom)

^d STOCKPORT NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

BIOLOGICAL MARKER; FATTY ACID BINDING PROTEIN; TROPONIN T;

ACUTE HEART INFARCTION; ADULT; ARTICLE; CARDIAC TROPONIN 1 CLIA; CLINICAL ASSESSMENT TOOL; CLINICAL FEATURE; CONTROLLED STUDY; CORONARY ARTERY OBSTRUCTION; DISEASE EXACERBATION; EMERGENCY WARD; FEMALE; HEART DEATH; HEART DISEASE; HIGH RISK PATIENT; HOSPITAL ADMISSION; HOSPITAL DISCHARGE; HUMAN; LOW RISK PATIENT; MAJOR CLINICAL STUDY; MALE; MANCHESTER ACUTE CORONARY SYNDROME DECISION RULE; OBSERVATIONAL STUDY; PREDICTIVE VALUE; PRIORITY JOURNAL; PROTEIN BLOOD LEVEL; RISK ASSESSMENT; SENSITIVITY AND SPECIFICITY; THORAX PAIN; VALIDATION STUDY;

ACUTE CORONARY SYNDROME; ADULT; AGED; BIOLOGICAL MARKERS; DECISION SUPPORT TECHNIQUES; EMERGENCY SERVICE, HOSPITAL; ENGLAND; HOSPITALIZATION; HUMANS; INCIDENCE; LOGISTIC MODELS; MIDDLE AGED; MYOCARDIAL INFARCTION; MYOCARDIAL REVASCULARIZATION; PATIENT DISCHARGE; PATIENT SELECTION; PREDICTIVE VALUE OF TESTS; PREVALENCE; PROGNOSIS; PROSPECTIVE STUDIES; REPRODUCIBILITY OF RESULTS; RISK ASSESSMENT; RISK FACTORS; UNNECESSARY PROCEDURES;

EID: 84906790197     PISSN: 13556037     EISSN: 1468201X     Source Type: Journal    
DOI: 10.1136/heartjnl-2014-305564     Document Type: Article

References (30)

1. The Health and Social Care Information Centre. Hospital Episode Statistics, Admitted Patient Care-England, 2012-13: Primary diagnosis, 3 characters table. http://www.hesonline.nhs.uk (accessed 25 Nov 2013).
2. Goodacre S, Cross E, Arnold J, et al. The health care burden of acute chest pain. Heart 2005;91:229-30.
3. Reiter M, Twerenbold R, Reichlin T, et al. Early diagnosis of acute myocardial infarction in the elderly using more sensitive cardiac troponin assays. Eur Heart J 2011;32:1379-89.
4. Body R, Carley S, McDowell G, et al. Rapid exclusion of acute myocardial infarction in patients with undetectable troponin using a high-sensitivity assay. J Am Coll Cardiol 2011;58:1332-9.
5. Body R, McDowell G, Carley S, et al. Do risk factors for chronic coronary heart disease help diagnose acute myocardial infarction in the Emergency Department? Resuscitation 2008;79:41-5.
6. Body R, Carley S, McDowell G, et al. Diagnosing acute myocardial infarction with troponins: How low can you go? Emerg Med J 2009;27:292-6.
7. Body R, Griffith CA, Keevil B, et al. Choline for diagnosis and prognostication of acute coronary syndromes in the Emergency Department. Clinica Chimica Acta 2009;404:89-94.
8. Body R, Carley S, McDowell G, et al. Can a modified thrombolysis in myocardial infarction risk score outperform the original for risk stratifying emergency department patients with chest pain? Emerg Med J 2009;26:95-9.
9. Body R, Carley S, Wibberley C, et al. The value of symptoms and signs in the emergent diagnosis of acute coronary syndromes. Resuscitation 2010;81:281-6.
10. Apple FS, Jaffe AS. Clinical implications of a recent adjustment to the high-sensitivity cardiac troponin T assay: user beware. Clin Chem 2012;58:1599-600.
11. Thygesen K, Alpert JS, Jaffe AS, et al. Third Universal Definition of Myocardial Infarction. J Am Coll Cardiol 2012;60:1581-98.
12. Giannitsis E, Becker M, Kurz K, et al. High-sensitivity cardiac troponin T for early prediction of evolving non-ST-segment elevation myocardial infarction in patients with suspected acute coronary syndrome and negative troponin results on admission. Clin Chem 2010;56:642-50.
13. Mueller M, Biener M, Vafaie M, et al. Absolute and relative kinetic changes of high-sensitivity cardiac troponin T in acute coronary syndrome and in patients with increased troponin in the absence of acute coronary syndrome. Clin Chem 2011;58:209-18.
14. Stiell IG, Wells GA. Methodologic standards for the development of clinical decision rules in emergency medicine. Ann Emerg Med 1999;33:437-47. (Pubitemid 29157570)
15. Panju AA, Hemmelgam BR, Guyatt GH, et al. The rational clinical examination: is this patient having a myocardial infarction. JAMA 1998;280:1256-63. (Pubitemid 28469233)
16. Goodacre S, Locker T, Morris F, et al. How useful are clinical features in the diagnosis of acute, undifferentiated chest pain? Acad Emerg Med 2002;9: 203-8. (Pubitemid 34205469)
17. Carley SD, Jenkins M, Mackway-Jones K. Body surface mapping versus the standard 12 lead ECG in the detection of myocardial infarction amongst emergency department patients: a Bayesian approach. Resuscitation 2005;64:309-14. (Pubitemid 40298786)
18. Herren KR, Mackway-Jones K, Richards CR, et al. Is it possible to exclude a diagnosis of myocardial damage within six hours of admission to an emergency department? Diagnostic cohort study. BMJ 2001;323:372-4. (Pubitemid 32762461)
19. Spirivulis PC, Da Silva JA, Jacobs IG, et al. The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments. Med Jf Aust 2006;184:208-12.
20. Steurer J, Held U, Schmid D, et al. Clinical value of diagnostic instruments for ruling out acute coronary syndrome in patients with chest pain: systematic review. Emerg Med J 2010;27:896-902.
21. Body R. Clinical decision rules for acute coronary syndromes: the specifics. Emerg Med J 2010;27:895.
22. Than M, Cullen L, Reid CM, et al. A 2-h diagnostic protocol to assess patients with chest pain symptoms in the Asia-Pacific region (ASPECT): a prospective observational validation study. Lancet 2011;377:1077-84.
23. Than M, Cullen L, Aldous S, et al. 2-Hour Accelerated diagnostic protocol to assess patients with chest pain symptoms using contemporary troponins as the only biomarker. J Am Coll Cardiol 2012;59:2091-8.
24. McCord J, Nowak RM, Mccullough PA, et al. Ninety-minute exclusion of acute myocardial infarcdtion by use of quantitative point-of-care testing of myoglobin and troponin I. Circulation 2001;104:1483-8. (Pubitemid 32917339)
25. Goodacre SW, Bradburn M, Cross E, et al. The Randomised Assessment of Treatment using Panel Assay of Cardiac Markers (RATPAC) trial: a randomised controlled trial of point-of-care cardiac markers in the emergency department. Heart 2011;97:190-6.
26. Fitzgerald P, Goodacre SW, Cross E, et al. Cost-effectiveness of point-of-care biomarker assessment for suspected myocardial infarction: the randomized assessment of treatment using panel assay of cardiac markers (RATPAC) trial. Acad Emerg Med 2011;18:488-95.
27. Reichlin T, Schindler C, Drexler B, et al. One-hour rule-out and rule-in of acute myocardial infarction using high-sensitivity cardiac troponin T. Arch Intern Med 2012;172:1211-18.
28. Keller T, Zeller T, Ojeda F, et al. Serial changes in highly sensitive troponin I assay and early diagnosis of myocardial infarction. JAMA 2011;306:2684-93.
29. Backus BE, Six AJ, Kelder JC, et al. Chest pain in the Emergency Room: a multicentre validation of the HEART score. Critical Pathways in Cardiology 2010;9:164-9.
30. Fox KAA, Dabbous OH, Goldberg RJ, et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational study (GRACE). BMJ 2006;333:1091-4. (Pubitemid 44863647)