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Several troponin-based risk-stratification strategies for emergency department (ED) patients with chest pain exist, and high-sensitivity troponin assays may allow faster and more-sensitive evaluations. Unfortunately, most prior studies evaluated a specific test (troponin I or troponin T) and a specific strategy (single, early repeated, or delayed repeated measurements) and are not applicable across all practice environments.
To develop and validate a risk-assessment tool that can be applied across testing strategies, researchers pooled data from 15 international cohorts of ED patients evaluated for acute coronary syndrome. Patients with ST-elevation myocardial infarction were excluded. Among 22,651 patients, MI was diagnosed in 15%. Risk for…