1-h High-Sensitivity Troponin Rule-Out and Rule-In Approach

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One-hour rule-out and rule-in of acute myocardial infarction using high-sensitivity cardiac troponin T.

BACKGROUND High-sensitivity cardiac troponin (hs-cTn) assays seem to improve the early diagnosis of acute myocardial infarction (AMI), but it is unknown how to best use them in clinical practice. Our objective was to develop and validate an algorithm for rapid rule-out and rule-in of AMI. METHODS A prospective multicenter study enrolling 872 unselected patients with acute chest pain presentin...

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Immediate Rule-Out of Acute Myocardial Infarction Using Electrocardiogram and Baseline High-Sensitivity Troponin I.

AIMS Serial measurements of high-sensitivity troponin are used to rule out acute myocardial infarction (AMI) with an assay specific cutoff at the 99th percentile. Here, we evaluated the performance of a single admission troponin with a lower cutoff combined with a low risk electrocardiogram (ECG) to rule out AMI. METHODS Troponin I measured with a high-sensitivity assay (hs-TnI) was determine...

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High-sensitivity troponin assays and the early rule-out of acute myocardial infarction

Many patients self-present or are referred by primary care to the emergency department with chest pain because of the potential that they may be suffering an acute myocardial infarction, one of the most common causes of death worldwide. Owing to diagnostic uncertainty, the majority of these patients are admitted, and, in some centres, chest pain is responsible for up to 40% of all unplanned hos...

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Copeptin adds to high-sensitivity troponin T in rapid rule out of acute myocardial infarction.

Karakas and colleagues (1) reported on copeptin and high-sensitivity troponin T (hsTnT) in a substudy of ROMICAT (Rule Out Myocardial Infarction by Computed Tomography) (2) that evaluated coronary computed tomography for ruling out myocardial infarction in lowto intermediate-risk patients with chest pain who were eligible for coronary computed tomography and subsequent coronary angiography. The...

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Economic evaluation of the one-hour rule-out and rule-in algorithm for acute myocardial infarction using the high-sensitivity cardiac troponin T assay in the emergency department

BACKGROUND The 1-hour (h) algorithm triages patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED) towards "rule-out," "rule-in," or "observation," depending on baseline and 1-h levels of high-sensitivity cardiac troponin (hs-cTn). The economic consequences of applying the accelerated 1-h algorithm are unknown. METHODS AND FINDINGS We performed a...

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ژورنال

عنوان ژورنال: Journal of the American College of Cardiology

سال: 2018

ISSN: 0735-1097

DOI: 10.1016/j.jacc.2018.05.041