Efficacy and safety of a 0/1-h high-sensitivity cardiac troponin I (hs-cTnI) protocol to rule out acute coronary syndrome over a one-year period

Vessel plus Pub Date : 2023-01-01 DOI:10.20517/2574-1209.2022.34

Kelly Perryman, David Winchester, M. Massoomi, E. Warren, Linda Morris, S. Beal, Nila S. Radhakrishnan, U. Ghaffar, Jacob Sammon, J. Raman, Marsha Lewis, D. Crabb, Liam, Holtzman, B. Allen

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Abstract

Aim: Evaluate the diagnostic and prognostic performance of the ESC 0/1H Algorithm and its utility in safely discharging patients with suspected Acute Coronary Syndrome (ACS) in the Emergency Department. Methods: This analysis is a retrospective cohort study of 3,156 patients presenting to an academic medical center emergency department (ED) between May 20, 2019 and May 31, 2020. After completing the Beckman Coulter Access High Sensitivity Troponin I (hs-TnI) assay per current institution protocol (T0, T1H, T3H), patients identified to have symptoms concerning ACS were retrospectively analyzed using the ESC 0/1H Algorithm to assess the safety and efficacy of a rule-out algorithm for early discharge. Results: The negative predictive value (NPV) of the protocol (T 0 < 6 pg/mL; or females with T 0 ≤ 15 pg/mL and T 1 ≤ 15 pg/mL; or males with T 0 ≤ 20 pg/mL and T 1 ≤ 20 pg/mL) was 99.4% (95%CI: 99.0-99.7%) for acute myocardial injury at the initial ED visit (index ED visit) and/or 30-day cardiac-related death. The negative

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0/1-h高敏感性心肌肌钙蛋白I (hs-cTnI)方案在一年内排除急性冠状动脉综合征的有效性和安全性

目的:评价ESC 0/1H算法在急诊科疑似急性冠脉综合征(ACS)患者安全出院中的诊断和预后效果。方法:本分析是一项回顾性队列研究，纳入了2019年5月20日至2020年5月31日在学术医疗中心急诊科(ED)就诊的3156例患者。在完成当前机构方案(T0、T1H、T3H)的Beckman Coulter Access高灵敏度肌钙蛋白I (hs-TnI)检测后，使用ESC 0/1H算法对确定有ACS症状的患者进行回顾性分析，以评估早期出院排除算法的安全性和有效性。结果:该方案的阴性预测值(NPV)为t0 < 6 pg/mL;t0≤15pg /mL, t1≤15pg /mL;t0≤20 pg/mL和t1≤20 pg/mL的男性患者在ED首次就诊(指数ED就诊)时急性心肌损伤和/或30天心脏相关死亡的发生率为99.4% (95%CI: 99.0-99.7%)。消极的

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Vessel plus

CiteScore

1.80

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0.00%

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