Miller et al reported the ACI-TIPI (Acute Cardiac Ischemia Time-Insensitive Predictive Instrument) tool for evaluating an Asian adult with chest pain. The authors are from multiple institutions in the United States and Singapore.
Patient selection: Asian male with chest pain
Parameters:
(1) age in years
(2) sex
(3) chest pain as primary or secondary complaint
(4) Q waves
(5) ST segment elevation
(6) ST segment depression
(7) T wave elevation
(8) T wave inversion
Parameter |
Finding |
Points |
age |
<= 40 years |
-1.441 |
|
41 to 50 years |
0 |
|
> 50 years |
0.667 |
sex |
female |
0 |
|
male |
0.712 |
sex and age |
male > 50 years |
-0.416 |
|
other |
0 |
chest pain |
primary complaint |
2.113 |
|
secondary complaint |
1.231 |
|
neither |
0 |
Q waves |
normal |
0 |
|
abnormal |
0.616 |
ST segment elevation |
no |
0 |
|
yes |
1.314 |
ST segment depression |
no |
0 |
|
yes |
0.993 |
T wave elevation |
no |
0 |
|
yes |
1.095 |
T wave inversion |
no |
0 |
|
yes |
1.127 |
ST segment and T wave |
ST segment depressed and T wave inversion |
-0.314 |
|
other |
0 |
where:
• ST segment and T wave changes may be exclusive.
X =
= SUM(points for all of the parameters) - 3.993
probability of acute coronary syndrome =
= 1/(1+EXP((-1)*X))
Performance:
• The area under the ROC curve is 0.72.
Specialty: Cardiology