Key result
T-MACS decision aid shows highest accuracy for predicting AMI and 30-day MACE.
Why the study?
This study evaluated the diagnostic performance of the Manchester Acute Coronary Syndrome (MACS) rule and its derivations to enhance evidence for their clinical use.
Do MACS, T-MACS, or HE-MACS decision aids accurately diagnose AMI and 30-day MACE in adult ED patients with suspected cardiac chest pain?
Population
Adult ED patients with suspected cardiac chest pain and inconclusive findings requiring ACS risk-stratification
Comparison
MACS vs T-MACS vs HE-MACS decision aids
Design
Systematic review and meta-analysis
Follow-up
30-day
Authors
Loading...
T-MACS supports safe early discharge for low-risk ED chest pain; confirms superior accuracy over MACS variants for AMI and 30-day MACE.
Meta-Analysis
Do MACS, T-MACS, or HE-MACS decision aids accurately diagnose AMI and 30-day MACE in adult ED patients with suspected cardiac chest pain?
Effect estimate: AUC 0.859 (T-MACS for AMI) (95% CI 0.824-0.887)
T-MACS exhibits very good diagnostic performance in predicting both AMI and MACE, making it a highly promising tool for managing patients with acute chest pain in the emergency department.
Dizaji et al. (2024) conducted a meta-analysis in Suspected acute coronary syndrome. MACS, T-MACS, and HE-MACS decision aids was evaluated on Diagnosis of acute myocardial infarction (AMI) and 30-day major adverse cardiac outcomes (MACEs) (AUC 0.859 (T-MACS for AMI), 95% CI 0.824-0.887). The Troponin-only MACS (T-MACS) decision aid showed the highest accuracy for predicting acute myocardial infarction (AUC 0.859; 95% CI 0.824-0.887) and 30-day MACE.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: