Ruling Out Acute Myocardial Infarction with a 2-Hour Algorithm

A simple algorithm consisting of two criteria using high-sensitivity cardiac troponin measures yields accurate triage of patients with suspected AMI.

Cardiologists are frequently called to emergency departments to evaluate patients with symptoms suggestive of acute coronary syndrome (ACS). In patients with normal electrocardiograms, a simple, rapid algorithm would be extremely valuable in determining the probability of ACS. These investigators tested a diagnostic algorithm incorporating high-sensitivity cardiac troponin-T (hs-cTnT) values on presentation and absolute changes within the first 2 hours.

The industry-supported study included 1148 unselected patients in a derivation cohort and 517 in an external validation cohort. All had suspected acute myocardial infarction (AMI), which was the final diagnosis in 16.3% and 9.1% of the derivation and validation cohorts, respectively. AMI rule…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Ruling Out Acute Myocardial Infarction with a 2-Hour Algorithm

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Reviewing Author