Validation of Two Decision Rules for Predicting Risk for Acute Myocardial Infarction

Both the Manchester Acute Coronary Syndromes (MACS) and troponin-only MACS decision rules identify patients at very low risk for AMI, but outpatient testing may be needed.

Researchers evaluated the Manchester Acute Coronary Syndromes (MACS) and troponin-only MACS (T-MACS) rules in a secondary analysis of data for 1244 patients who presented to two emergency departments (EDs) in New Zealand and Australia with a complaint of at least 5 minutes of chest pain concerning for acute coronary syndrome (ACS).

MACS and T-MACS probabilities for ACS were calculated with a formula using points assigned for the following variables: ischemic electrocardiogram changes, diaphoresis, vomiting, elevated blood pressure, history of angina, radiating pain, and biomarkers (presenting high-sensitivity troponin T [hs-TnT] level and heart fatty acid–binding protein for MACS; only hs-TnT for T-MACS). The primary outcome was 30-day diagn…

Reviewing Author

Jennifer L. Wiler, MD, MBA, FACEP

Disclosures

Leadership Positions in Professional SocietiesColorado Medical Society (Member, Board of Directors)

Jennifer L. Wiler, MD, MBA, FACEP

Disclosures

Leadership Positions in Professional SocietiesColorado Medical Society (Member, Board of Directors)

Validation of Two Decision Rules for Predicting Risk for Acute Myocardial Infarction

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Reviewing Author