WFRF:(Christenson Robert H.)
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Prognostic Utility of a Modified HEART Score in Chest Pain Patients in the Emergency Department
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- McCord, James (författare)
- Henry Ford Hlth Syst, Henry Ford Heart & Vasc Inst, 2799 West Grand Blvd K-14, Detroit, MI 48202 USA.
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- Cabrera, Rafael (författare)
- Henry Ford Hlth Syst, Henry Ford Heart & Vasc Inst, 2799 West Grand Blvd K-14, Detroit, MI 48202 USA.
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- Lindahl, Bertil, 1957- (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)
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- Henry Ford Hlth Syst, Henry Ford Heart & Vasc Inst, 2799 West Grand Blvd K-14, Detroit, MI 48202 USA Institutionen för medicinska vetenskaper (creator_code:org_t)
- LIPPINCOTT WILLIAMS & WILKINS, 2017
- 2017
- Engelska.
- Ingår i: Circulation. Cardiovascular Quality and Outcomes. - : LIPPINCOTT WILLIAMS & WILKINS. - 1941-7713 .- 1941-7705. ; 10:2
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- Background-The TRAPID-AMI trial study ( High-Sensitivity Troponin-T Assay for Rapid Rule-Out of Acute Myocardial Infarction) evaluated high-sensitivity cardiac troponin-T ( hs-cTnT) in a 1-hour acute myocardial infarction ( AMI) exclusion algorithm. Our study objective was to evaluate the prognostic utility of a modified HEART score ( m-HS) within this trial. Methods and Results-Twelve centers evaluated 1282 patients in the emergency department for possible AMI from 2011 to 2013. Measurements of hs-cTnT ( 99th percentile, 14 ng/L) were performed at 0, 1, 2, and 4 to 14 hours. Evaluation for major adverse cardiac events ( MACEs) occurred at 30 days ( death or AMI). Low-risk patients had an m-HS <= 3 and had either hs-cTnT<14 ng/L over serial testing or had AMI excluded by the 1-hour protocol. By the 1-hour protocol, 777 ( 60%) patients had an AMI excluded. Of those 777 patients, 515 ( 66.3%) patients had an m-HS <= 3, with 1 ( 0.2%) patient having a MACE, and 262 ( 33.7%) patients had an m-HS <= 4, with 6 ( 2.3%) patients having MACEs ( P=0.007). Over 4 to 14 hours, 661 patients had a hs-cTnT<14 ng/L. Of those 661 patients, 413 ( 62.5%) patients had an m-HS <= 3, with 1 ( 0.2%) patient having a MACE, and 248 ( 37.5%) patients had an m-HS >= 4, with 5 ( 2.0%) patients having MACEs ( P=0.03). Conclusions-Serial testing of hs-cTnT over 1 hour along with application of an m-HS identified a low-risk population that might be able to be directly discharged from the emergency department.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- mortality
- myocardial infarction
- patient discharge
- prognosis
- troponin-T
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- Circulation. Cardiovascular Quality and Outcomes (Sök värdpublikationen i LIBRIS)
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