Than et al used an accelerated diagnostic protocol (ADP) for evaluating a patient with acute chest pain in the Emergency Department (ED). This can help to identify a patient who is low short-term risk for major adverse cardiac events (MACE) and who can be safely discharged. The authors are from multiple institutions in Australia, New Zealand, Singapore and the United States and are participants in the ADAPT trial.
Patient selection: acute chest pain in the ED
Criteria for low risk - all of the following:
(1) no new ischemic changes on the initial ECG
(2) TIMI score for unstable angina/NSTEMI = 0
(3) serum troponin I level on arrival (0 hour) less than the upper limit of normal (ULN)
(4) serum troponin I level at 2 hours after arrival less than the upper limit of normal
A patient who is low risk can be discharged from the ED with early follow-up.
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