Adverse Cardiac Events Rare in Certain Chest Pain Patients

The study suggests patients presenting with a normal ECG, TIMI score of zero, and negative highly sensitive troponin I assay may be safely discharged from the ED, but it needs validation.

In the ongoing search for the best approach to determine which patients with chest pain can be safely discharged from the emergency department (ED), researchers evaluated outcomes in adult patients who presented with nontraumatic chest pain and were evaluated for acute coronary syndrome at an academic hospital in Australia. Patients were considered low risk if they had a normal electrocardiogram (ECG), a presentation TIMI risk score of zero (see table), and an initial highly sensitive troponin I level ≤99th percentile.

The primary outcome was experiencing a major adverse cardiac event (MACE) — defined as death, cardiac arrest, revascularization, cardiogenic shock, arrhythmia, or prevalent (the cause for the presentation) or incident (occurri…

Reviewing Author

Diane Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)

Diane Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)