Key result
The novel diagnostic algorithm incorporating high-sensitivity troponin T safely discharged 90.7% of patients with suspected acute coronary syndrome, with only 1.25% experiencing a major cardiac event at 30 days.
Why the study?
Does a novel diagnostic algorithm using high-sensitivity troponin T safely evaluate patients with suspected acute coronary syndrome and reduce length of hospital stay?
Observational (n=528)
No
Does a novel diagnostic algorithm using high-sensitivity troponin T safely evaluate patients with suspected acute coronary syndrome and reduce length of hospital stay?
A novel diagnostic algorithm using high-sensitivity troponin T is safe for evaluating suspected acute coronary syndrome, achieving a 99% negative predictive value and an average emergency department length of stay of 4.5 hours.
Introduction: Chest pain represents 5 to 10% of annual visits to emergency departments. Its diagnosis is sometimes difficult, with the added problem of inappropriate discharge of patients with acute coronary syndrome or unnecessary hospitalizations.This has led to the development of different algorithms for the evaluation of these patients.Objective: The aim of this study was to validate, in terms of safety and length of hospital stay, a novel algorithm incorporatedin our center, which includes measurement of high-sensitivity troponin T in patients with suspected acute coronary syndrome.Methods: The study included 528 consecutive patients attending the emergency department with suspected acute coronarysyndrome and evaluated according to the chest pain unit protocol. Clinical and laboratory variables and functional tests wereanalyzed. Follow-up at 30 days was performed in all the patients.Results: After observation, 90.7% of the patients were discharged and 1.25% presented a cardiovascular event during follow-up,represented by percutaneous coronary intervention and hospitalization due to acute coronary syndrome. The specificity of theglobal algorithm for the diagnosis of acute coronary syndrome was 97% with a negative predictive value of 99%. Emergencydepartment length of stay was 4.5 ± 2.5 hours for all the patients.Conclusion: The novel algorithm incorporated in our center with measurement of high-sensitivity troponin T in patientswith suspected acute coronary syndrome has proved to be safe, as it prevents the discharge of patients with acute coronarysyndrome and at the same time reduces emergency department length of stay.
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Costabel et al. (2014) conducted an observational in Suspected acute coronary syndrome (n=528). Diagnostic algorithm including high-sensitivity cardiac troponin T was evaluated on Major cardiac events at 30 days (cardiac death, percutaneous coronary intervention, coronary artery bypass graft surgery, or hospitalization due to acute coronary syndrome). The novel diagnostic algorithm incorporating high-sensitivity troponin T safely discharged 90.7% of patients with suspected acute coronary syndrome, with only 1.25% experiencing a major cardiac event at 30 days.
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