Pickering et al reported a model for identifying patients with chest pain in the Emergency Department who are low risk for acute myocardial infarction. The authors are from multiple institutions in Australia, New Zealand and Singapore.
Patient selection: age >=18 years of age, symptoms suggestive of ACS, without ST segment elevation in the ECG
Parameters:
(1) Emergency Department Assessment of Chest Pain Score (EDACS), from -8 to 38
(2) serum high sensitivity cardiac troponin T or troponin I in ng/L
EDACS
Troponin T
Troponin I
<16
<7 ng/L
NA
<15
NA
<8 ng/L
The sensitivity of the two strategies was 98.5%.
The model allocated about 30% of patients to the low risk group. The low risk group could be discharged quickly.
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