Key result
A high-sensitivity cardiac troponin I threshold of <2 ng/L at presentation ruled out acute myocardial infarction with a sensitivity of 99.0% (95% CI, 94.4%-100%) and NPV of 99.8%.
Why the study?
Does a single baseline high-sensitivity cardiac troponin I measurement safely rule out acute myocardial infarction in patients presenting with symptoms of acute coronary syndrome?
Population
1,871 patients presenting to a tertiary emergency department with symptoms of acute coronary syndrome
Design
Cohort
Authors
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May support single hs-cTnI testing for early T1MI rule-out in ED; leaves open prospective validation before practice change.
Observational (n=1,871)
No
Does a single baseline high-sensitivity cardiac troponin I measurement safely rule out acute myocardial infarction in patients presenting with symptoms of acute coronary syndrome?
Effect estimate: Sensitivity 99.0% (95% CI 94.4%-100%)
A single baseline hs-cTnI <2 ng/L using the Beckman Coulter Access assay safely rules out acute myocardial infarction with 99% sensitivity and 99.8% NPV.
Greenslade et al. (2018) conducted an observational in acute coronary syndrome (n=1,871). High-sensitivity cardiac troponin I (hs-cTnI) assay <2 ng/L threshold was evaluated on type 1 myocardial infarction (T1MI) (Sensitivity 99.0%, 95% CI 94.4%-100%). A high-sensitivity cardiac troponin I threshold of <2 ng/L at presentation ruled out acute myocardial infarction with a sensitivity of 99.0% (95% CI, 94.4%-100%) and NPV of 99.8%.
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