Comparison of the Efficacy and Safety of Early Rule-Out Pathways for Acute Myocardial Infarction

High-sensitivity cardiac troponin assays enable myocardial infarction to be ruled out earlier, but the optimal approach is uncertain. We compared the European Society of Cardiology rule-out pathway with a pathway that incorporates lower cardiac troponin concentrations to risk stratify patients. Pati...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2017-04, Vol.135 (17), p.1586-1596
Main Authors: Chapman, Andrew R, Anand, Atul, Boeddinghaus, Jasper, Ferry, Amy V, Sandeman, Dennis, Adamson, Philip D, Andrews, Jack, Tan, Stephanie, Cheng, Sheun F, D'Souza, Michelle, Orme, Kate, Strachan, Fiona E, Nestelberger, Thomas, Twerenbold, Raphael, Badertscher, Patrick, Reichlin, Tobias, Gray, Alasdair, Shah, Anoop S V, Mueller, Christian, Newby, David E, Mills, Nicholas L
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - blood
Acute Coronary Syndrome - diagnosis
Acute Coronary Syndrome - mortality
Age Factors
Aged
Aged, 80 and over
Biomarkers - blood
Decision Support Techniques
Female
Health Status
Humans
Male
Middle Aged
Myocardial Infarction - blood
Myocardial Infarction - diagnosis
Myocardial Infarction - mortality
Original s
Predictive Value of Tests
Prognosis
Risk Assessment
Risk Factors
Scotland
Sex Factors
Time Factors
Troponin I - blood
Up-Regulation
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Summary:High-sensitivity cardiac troponin assays enable myocardial infarction to be ruled out earlier, but the optimal approach is uncertain. We compared the European Society of Cardiology rule-out pathway with a pathway that incorporates lower cardiac troponin concentrations to risk stratify patients. Patients with suspected acute coronary syndrome (n=1218) underwent high-sensitivity cardiac troponin I measurement at presentation and 3 and 6 or 12 hours. We compared the European Society of Cardiology pathway (
ISSN:0009-7322
1524-4539
DOI:10.1161/circulationaha.116.025021