Clinical Chemistry Score of Kavsak et al for the Diagnosis of Acute Myocardial Infarction in the Emergency Department

Description

Kavsak et al developed a clinical chemistry score (CCS) for evaluating a patient in the emergency department with symptoms of the acute coronary sydnrome (ACS). The authors are from McMaster University, Royal Brisbane and Women's Hospital, Christchurch Hospital, University of Otago and the National University of Singapore.

Patient selection: presentation to emergency department with symptoms of acute coronary syndrome

Outcome: 30-day myocardial infarction or death

Parameters:

(1) glucose in mmol/L (specimen not specified)

(2) eGFR in mL per min per 1.73 square meter

(3) serrum high-sensitivity troponin (either I or T) in ng/L

Parameters	Findings	Points
glucose	< 5.6	0
	>= 5.6	1
eGFR	>= 90	0
	< 90	1

Troponin I	Troponin T	Points
< 4	< 8 ng/L	0
4 to 14	8 to 18	1
15 to 30	19 to 30	2
> 30	> 30	3

total score =

= (SUM(points for all 3 parameters)

Interpretation:

• minimum score: 0

• maximum score: 5

• The higher the score the greater the risk of the outcome.

• The risk varied by troponin method and cohort location.

Score	Troponin I	Troponin T
0	0, 0, 0, 0	0, 0, 0, 0.7
1	1, 0, 0.6, 0.9	2, 0.4, 3.1, 3.9
2	3.8, 0.6, 0.8, 5.8	4.4, 2.8, 3.0, 7.4
3	13.3, 7.1, 12.3, 14.9	12.7, 8.3, 14.3, 15.8
4	34.9, 28.9, 51.5, 44.4	28.6, 17, 58.1, 41.7
5	66.4,63.4, 89.4, 72.0	48.8, 54.4, 76.7. 63.7

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Clinical Chemistry Score of Kavsak et al for the Diagnosis of Acute Myocardial Infarction in the Emergency Department

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