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.
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