Two-Hour ACS Rule-Out Pathway: Not Validated Yet

There were no major cardiac events at 30 days among low-risk patients undergoing a standard 6-hour evaluation, but the study was underpowered to validate a 2-hour rule-out pathway.

To prospectively validate a 2-hour acute coronary syndrome (ACS) rule-out pathway in low-risk patients with chest pain (NEJM JW Emerg Med Jun 29 2012), researchers studied 177 adult patients at a single Australian emergency department between 2012 and 2013. Enrolled patients had chest pain lasting more than 10 minutes within the preceding 24 hours, a Thrombolysis in Myocardial Infarction (TIMI) score of 0, and no ischemic electrocardiogram changes. Patients underwent an ACS rule-out evaluation with troponin measurement (TnI-Ultra) at 0 and 3 or 6 hours, and an additional measurement at 2 hours.

At 30 days, no patients required revascularization or had a major adverse cardiac event (myocardial infarction, death, cardiac arrest, cardiogenic sh…

Reviewing Author

Cheryl Lynn Horton, MD

Disclosures

Speaker’s bureauAirway Management Education Center

Cheryl Lynn Horton, MD

Disclosures

Speaker’s bureauAirway Management Education Center

Two-Hour ACS Rule-Out Pathway: Not Validated Yet

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Reviewing Author