Key result
A 4-hour accelerated diagnostic protocol demonstrated a negative predictive value of 91% for predicting 30-day major adverse cardiac events in patients with suspected ischemic chest pain.
Why the study?
Does a 4-hour accelerated diagnostic protocol using chest pain, ECG, and troponin T predict 30-day MACE in patients with suspected ischemic chest pain?
Population
132 patients aged over 18 years with suspected ischemic chest pain presenting within 12 hours of onset along…
Design
Cohort
Follow-up
30-days
Authors
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Warrants caution before routine adoption due to excess MACE in low-risk patients; leaves open protocol optimization in larger prospective studies.
Observational (n=110)
No
Does a 4-hour accelerated diagnostic protocol using chest pain, ECG, and troponin T predict 30-day MACE in patients with suspected ischemic chest pain?
Effect estimate: NPV 91% (95% CI 0.83-0.96)
Absolute Event Rate: 8.4% vs 60%
A 4-hour accelerated diagnostic protocol using chest pain, ECG, and troponin T showed high specificity and negative predictive value for 30-day MACE, but the MACE rate in ADP-negative patients was higher than guideline recommendations, suggesting the need for additional testing.
Rao et al. (2012) conducted an observational in Suspected ischemic chest pain (n=110). 4-hour accelerated diagnostic protocol (ADP) vs. ADP positive (High-probability ACS) was evaluated on 30-day major adverse cardiac events (MACE) (NPV 91%, 95% CI 0.83-0.96). A 4-hour accelerated diagnostic protocol demonstrated a negative predictive value of 91% for predicting 30-day major adverse cardiac events in patients with suspected ischemic chest pain.
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