1. Derivation of a HEAR Pathway for Emergency Department Chest Pain Patients to Safely Avoid a Second Troponin Test
- Author
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Chen Chen, Yao Yu, Dongxu Chen, Canguang Cai, Yannan Zhou, Fengqing Liao, Alima Humarbek, Xuan Li, Zhenju Song, Zhan Sun, Chaoyang Tong, Chenling Yao, and Guorong Gu
- Subjects
HEAR pathway ,high-sensitivity cardiac troponin ,non-ST elevation myocardial infarction ,emergency department ,chest pain ,Medicine (General) ,R5-920 - Abstract
The study aims to develop a decision pathway based on HEAR score and 0 h high-sensitivity cardiac troponin T (hs-cTnT) to safely avoid a second troponin test for suspected non-ST elevation myocardial infarction (NSTEMI) in emergency departments. A HEAR score consists of history, electrocardiogram, age, and risk factors. A HEAR pathway is established using a Bayesian approach based on a predefined safety threshold of NSTEMI prevalence in the rule-out group. In total, 7131 patients were retrospectively enrolled, 582 (8.2%) with index visit NSTEMI and 940 (13.2%) with 180-day major adverse cardiovascular events (MACE). For patients with a low-risk HEAR score (0 to 2) and low 0 h hs-cTnT (
- Published
- 2023
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