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Prognostic Utility ...
Prognostic Utility of a Modified HEART Score in Chest Pain Patients in the Emergency Department
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- McCord, James (author)
- 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 (author)
- 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- (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)
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- Giannitsis, Evangelos (author)
- Univ Heidelberg Hosp, Dept Internal Med Cardiol Angiol & Pulmonol 3, Heidelberg, Germany.
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- Evans, Kaleigh (author)
- Henry Ford Hosp Hlth Syst, Dept Internal Med, Detroit, MI USA.
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- Nowak, Richard (author)
- Henry Ford Hlth Syst, Dept Emergency Med, Detroit, MI USA.
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- Frisoli, Tiberio (author)
- Henry Ford Hlth Syst, Henry Ford Heart & Vasc Inst, 2799 West Grand Blvd K-14, Detroit, MI 48202 USA.
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- Body, Richard (author)
- Cent Manchester Univ Hosp NHS Fdn Trust, Manchester, Lancs, England.
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- Christ, Michael (author)
- Paracelsus Med Univ, Gen Hosp, Dept Emergency & Crit Care Med, Nurnberg, Germany.
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- deFilippi, Christopher R. (author)
- Inova Heart & Vasc Inst, Dept Med, Falls Church, VA USA.
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- Christenson, Robert H. (author)
- Univ Maryland, Sch Med, Dept Pathol, Baltimore, MD 21201 USA.
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- Jacobsen, Gordon (author)
- Henry Ford Hlth Syst, Dept Publ Hlth Sci, Detroit, MI USA.
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- Alquezar, Aitor (author)
- Hosp Santa Creu & Sant Pau, Dept Emergency Med, Barcelona, Spain.
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- Panteghini, Mauro (author)
- Univ Milan, Sch Med, Dept Biomed & Clin Sci Luigi Sacco, Milan, Italy.
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- Melki, Dina (author)
- Karolinska Univ Hosp, Dept Cardiol, Karolinska Inst, Dept Med, Stockholm, Sweden.
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- Plebani, Mario (author)
- Univ Hosp Padova, Dept Lab Med, Padua, Italy.
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- Verschuren, Franck (author)
- Clin Univ St Luc, Brussels, Belgium.;Catholic Univ Louvain, Brussels, Belgium.
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- French, John (author)
- Liverpool Hosp, Sydney, NSW, Australia.;Univ New South Wales, Sydney, NSW, Australia.
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- Bendig, Garnet (author)
- Roche Diagnost Germany, Penzberg, Germany.
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- Weiser, Silvia (author)
- Roche Diagnost Germany, Penzberg, Germany.
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- Mueller, Christian (author)
- Univ Basel Hosp, Cardiol & Cardiovasc Res Inst Basel, Basel, Switzerland.
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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
- English.
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In: Circulation. Cardiovascular Quality and Outcomes. - : LIPPINCOTT WILLIAMS & WILKINS. - 1941-7713 .- 1941-7705. ; 10:2
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- mortality
- myocardial infarction
- patient discharge
- prognosis
- troponin-T
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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McCord, James
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Cabrera, Rafael
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Lindahl, Bertil, ...
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Giannitsis, Evan ...
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Evans, Kaleigh
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Nowak, Richard
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Frisoli, Tiberio
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Body, Richard
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Christ, Michael
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deFilippi, Chris ...
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Christenson, Rob ...
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Jacobsen, Gordon
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Alquezar, Aitor
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Panteghini, Maur ...
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Melki, Dina
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Plebani, Mario
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Verschuren, Fran ...
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French, John
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Bendig, Garnet
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Weiser, Silvia
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Mueller, Christi ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Circulation. Car ...
- By the university
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Uppsala University
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Karolinska Institutet