A 1-h Combination Algorithm Allows Fast Rule-Out and Rule-In of Major Adverse Cardiac Events

Journal of the American College of Cardiology

Volumn 67, Issue 13, 2016, Pages 1531-1540

  Mokhtari, Arash ^a,b   Borna, Catharina ^b,c   Gilje, Patrik ^a   Tydén, Patrik ^a   Lindahl, Bertil ^d   Nilsson, Hans Jörgen ^a   Khoshnood, Ardavan ^a,b   Björk, Jonas ^e   Ekelund, Ulf ^a,b  

^a LUND UNIVERSITY HOSPITAL   (Sweden)

^b LUND UNIVERSITY   (Sweden)

^c Helsingborg General Hospital   (Sweden)

^d UPPSALA UNIVERSITY   (Sweden)

^e LUND UNIVERSITY   (Sweden)

Author keywords

acute coronary syndrome; chest pain; diagnosis; myocardial infarction; sensitivity and specificity; unstable angina

Indexed keywords

TROPONIN T;

ACUTE HEART INFARCTION; ADULT; AGED; ARTICLE; ATRIOVENTRICULAR BLOCK; CARDIOGENIC SHOCK; CAUSE OF DEATH; COHORT ANALYSIS; CONTROLLED STUDY; DIAGNOSTIC ACCURACY; DIAGNOSTIC TEST ACCURACY STUDY; ELECTROCARDIOGRAPHY; EMERGENCY WARD; FEMALE; HEART ARREST; HEART VENTRICLE ARRHYTHMIA; HUMAN; INFORMED CONSENT; MAJOR CLINICAL STUDY; MALE; OBSERVATIONAL STUDY; PREDICTIVE VALUE; PRIORITY JOURNAL; PROSPECTIVE STUDY; SENSITIVITY AND SPECIFICITY; THORAX PAIN; UNSTABLE ANGINA PECTORIS; ALGORITHM; ANAMNESIS; BLOOD; CHEST PAIN; HEART DISEASES; HOSPITAL EMERGENCY SERVICE; MIDDLE AGED; STATISTICAL MODEL;

AGED; ALGORITHMS; CHEST PAIN; ELECTROCARDIOGRAPHY; EMERGENCY SERVICE, HOSPITAL; FEMALE; HEART DISEASES; HUMANS; LIKELIHOOD FUNCTIONS; MALE; MEDICAL HISTORY TAKING; MIDDLE AGED; PREDICTIVE VALUE OF TESTS; PROSPECTIVE STUDIES; TROPONIN T;

EID: 85008912351     PISSN: 07351097     EISSN: 15583597     Source Type: Journal    
DOI: 10.1016/j.jacc.2016.01.059     Document Type: Article

References (30)

1. 1 Pitts, S.R., Niska, R.W., Xu, J., Burt, C.W., National Hospital Ambulatory Medical Care Survey: 2006 emergency department summary. Natl Health Stat Report, 2008, 1–38.
2. 2 Christenson, J., Innes, G., McKnight, D., et al. Safety and efficiency of emergency department assessment of chest discomfort. CMAJ 170 (2004), 1803–1807.
3. 3 Cullen, L., Greenslade, J., Merollini, K., et al. Cost and outcomes of assessing patients with chest pain in an Australian emergency department. Med J Aust 202 (2015), 427–432.
4. 4 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 172 (2012), 1211–1218.
5. 5 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 187 (2015), E243–E252.
6. 6 Roffi, M., Patrono, C., Collet, J.P., et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J 37 (2016), 267–315.
7. 7 Newby, L.K., Jesse, R.L., Babb, J.D., et al. ACCF 2012 expert consensus document on practical clinical considerations in the interpretation of troponin elevations: a report of the American College of Cardiology Foundation task force on Clinical Expert Consensus Documents. J Am Coll Cardiol 60 (2012), 2427–2463.
8. 8 Bossuyt, P.M., Reitsma, J.B., Bruns, D.E., et al. The STARD statement for reporting studies of diagnostic accuracy: explanation and elaboration. Ann Intern Med 138 (2003), W1–W12.
9. 9 Thygesen, K., Alpert, J.S., Jaffe, A.S., et al. Third universal definition of myocardial infarction. Eur Heart J 33 (2012), 2551–2567.
10. 10 Giannitsis, E., Kurz, K., Hallermayer, K., et al. Analytical validation of a high-sensitivity cardiac troponin T assay. Clin Chem 56 (2010), 254–261.
11. 11 Cullen, L., Than, M., Brown, A.F., et al. Comprehensive standardized data definitions for acute coronary syndrome research in emergency departments in Australasia. Emerg Med Australas 22 (2010), 35–55.
12. 12 Kline, J.A., Mitchell, A.M., Runyon, M.S., et al. Electronic medical record review as a surrogate to telephone follow-up to establish outcome for diagnostic research studies in the emergency department. Acad Emerg Med 12 (2005), 1127–1133.
13. 13 Hess, E.P., Brison, R.J., Perry, J.J., et al. Development of a clinical prediction rule for 30-day cardiac events in emergency department patients with chest pain and possible acute coronary syndrome. Ann Emerg Med 59 (2012), 115–125.e1.
14. 14 Body, R., Cook, G., Burrows, G., Carley, S., Lewis, P.S., Can emergency physicians ‘rule in’ and ‘rule out’ acute myocardial infarction with clinical judgement?. Emerg Med J 31 (2014), 872–876.
15. 15 Pauker, S.G., Kassirer, J.P., The threshold approach to clinical decision making. N Engl J Med 302 (1980), 1109–1117.
16. 16 Kline, J.A., Johnson, C.L., Pollack, C.V. Jr., et al. Pretest probability assessment derived from attribute matching. BMC Med Inform Decis Mak, 5, 2005, 26.
17. 17 Than, M., Herbert, M., Flaws, D., et al. What is an acceptable risk of major adverse cardiac event in chest pain patients soon after discharge from the emergency department?: a clinical survey. Int J Cardiol 166 (2013), 752–754.
18. 18 Keller, T., Zeller, T., Peetz, D., et al. Sensitive troponin I assay in early diagnosis of acute myocardial infarction. N Engl J Med 361 (2009), 868–877.
19. 19 Mendis, S., Thygesen, K., Kuulasmaa, K., et al. World Health Organization definition of myocardial infarction: 2008-09 revision. Int J Epidemiol 40 (2011), 139–146.
20. 20 Mueller, C., Biomarkers and acute coronary syndromes: an update. Eur Heart J 35 (2014), 552–556.
21. 21 Reichlin, T., Twerenbold, R., Maushart, C., et al. Risk stratification in patients with unstable angina using absolute serial changes of 3 high-sensitive troponin assays. Am Heart J 165 (2013), 371–378.e3.
22. 22 Hammerer-Lercher, A., Ploner, T., Neururer, S., et al. High-sensitivity cardiac troponin T compared with standard troponin T testing on emergency department admission: how much does it add in everyday clinical practice?. J Am Heart Assoc, 2, 2013, e000204.
23. 23 Chase, M., Robey, J.L., Zogby, K.E., Sease, K.L., Shofer, F.S., Hollander, J.E., Prospective validation of the Thrombolysis in Myocardial Infarction Risk Score in the emergency department chest pain population. Ann Emerg Med 48 (2006), 252–259.
24. 24 Ekelund, U., Nilsson, H.J., Frigyesi, A., Torffvit, O., Patients with suspected acute coronary syndrome in a university hospital emergency department: an observational study. BMC Emerg Med, 2, 2002, 1.
25. 25 Mokhtari, A., Dryver, E., Soderholm, M., Ekelund, U., Diagnostic values of chest pain history, ECG, troponin and clinical gestalt in patients with chest pain and potential acute coronary syndrome assessed in the emergency department. Springerplus, 4, 2015, 219.
26. 26 Chandra, A., Lindsell, C.J., Limkakeng, A., et al. Emergency physician high pretest probability for acute coronary syndrome correlates with adverse cardiovascular outcomes. Acad Emerg Med 16 (2009), 740–748.
27. 27 Than, M., Aldous, S., Lord, S.J., et al. A 2-hour diagnostic protocol for possible cardiac chest pain in the emergency department: a randomized clinical trial. JAMA Intern Med 174 (2014), 51–58.
28. 28 Backus, B.E., Six, A.J., Kelder, J.C., et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol 168 (2013), 2153–2158.
29. 29 Weinstock, M.B., Weingart, S., Orth, F., et al. Risk for clinically relevant adverse cardiac events in patients with chest pain at hospital admission. JAMA Intern Med 175 (2015), 1207–1212.
30. 30 Hess, E.P., Knoedler, M.A., Shah, N.D., et al. The chest pain choice decision aid: a randomized trial. Circ Cardiovasc Qual Outcomes 5 (2012), 251–259.