Rapid Rule-Out Protocol for Patients with Suspected Cardiac Chest Pain

The combination of TIMI score of zero at presentation, no new ischemic changes on initial electrocardiogram, and negative troponin results at zero and 2 hours had a sensitivity of 99.7%.

In a prospective observational study of 1975 patients who presented to two hospitals in Australia and New Zealand with chest pain suggestive of acute coronary syndrome, researchers assessed whether or not an accelerated diagnostic protocol could identify patients at low risk for major adverse cardiac events within 30 days. Patients with ST segment elevation on initial electrocardiogram (ECG) were excluded. Patients received usual care, including serial troponin testing, in accordance with international guidelines; each hospital used its standard troponin test.

The protocol consisted of a Thrombolysis in Myocardial Infarction (TIMI) score at presentation, initial ECG results, and troponin I concentrations at zero and 2 hours; patients with a …

Reviewing Author

J. Stephen Bohan, MD, MS, FACP, FACEP

Disclosures

RoyaltiesKlint Law Firm

Editorial boardsCritical Decisions in Emergency Medicine

J. Stephen Bohan, MD, MS, FACP, FACEP

Disclosures

RoyaltiesKlint Law Firm

Editorial boardsCritical Decisions in Emergency Medicine