Ruling Out Acute Coronary Syndromes: Troponin Is Essential, as Is Clinical Assessment

• Published in: Journal of the American College of Cardiology Vol. 74; no. 7; pp. 855 - 857
• Main Authors: Cediel, Germán, Bardají, Alfredo, Barrabés, José A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 20.08.2019; Elsevier Limited
• Subjects: Acute Coronary Syndrome; Acute coronary syndromes; acute myocardial infarction; Algorithms; Angina; Angina pectoris; Arrhythmia; Cardiology; clinical assessment; Electrocardiography; Heart; Heart attacks; high-sensitivity cardiac troponin; Humans; major adverse cardiac events; Myocardial Infarction; Pain; Patients; Troponin I; Ventricle; major adverse cardiac events; clinical assessment; high-sensitivity cardiac troponin; acute myocardial infarction; electrocardiography
• ISSN: 0735-1097; 1558-3597; 1558-3597
• DOI: 10.1016/j.jacc.2019.05.065

In this issue of the Journal, Nestelberger et al.(6)aimed to validate, in an external large cohort of patients evaluated for suspected ACS in the ED, the performance of the extended algorithm in the prediction of short-term MACE (death, cardiac arrest, AMI [including the index event], cardiogenic shock, sustained ventricular arrhythmia, or high-grade atrioventricular block) or MACE + UA (angina with coronary revascularization within 24 h) and compare it with that of the ESC hs-cTn 0/1 h algorithm. Analyses were performed in 3,123 patients from the APACE (Advantageous Predictors of Acute Coronary Syndrome Evaluation) study with no ST-segment elevation, a clear final diagnosis, and two 0/1 hs-cTn determinations available.