Key result
MACS and T-MACS rules identify patients at very low risk for AMI with ~99% sensitivity.
Why the study?
The Manchester Acute Coronary Syndromes (MACS) and Troponin-only MACS (T-MACS) rules require validation and comparison for predicting acute myocardial infarction in suspected ACS patients.
Do the MACS and T-MACS rules accurately predict acute myocardial infarction in patients presenting to the emergency department with chest pain?
Population
1244 patients presenting to ED with chest pain and suspected ACS in Australia and New Zealand
Comparison
MACS rule vs T-MACS rule for risk stratification
Design
Prospective observational study
Follow-up
30 days
Authors
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Supports early rule-out of AMI in low-risk ED chest pain; leaves open need for prospective trials before routine use.
Observational (n=1,244)
Yes
Do the MACS and T-MACS rules accurately predict acute myocardial infarction in patients presenting to the emergency department with chest pain?
Effect estimate: Sensitivity 99.1% (95% CI 95.2%-100%)
Both MACS and T-MACS rules accurately identify very low risk patients with suspected ACS, with T-MACS potentially allowing for more early discharges.
Greenslade et al. (2017) conducted an observational in Suspected acute coronary syndrome (n=1,244). MACS and T-MACS rules was evaluated on 30-day diagnosis of acute myocardial infarction (Sensitivity 99.1%, 95% CI 95.2%-100%). The MACS and T-MACS rules accurately identified patients at very low risk for acute myocardial infarction, both demonstrating a sensitivity of 99.1%.
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