Implementing the European Society of Cardiology 0-h/1-h algorithm in patients presenting very early after chest pain
| Autor: | Tetsuro Miyazaki, Shuo-Ju Chiang, Naozumi Kubota, Satoru Suwa, Masayuki Shiozaki, Yuji Nakazato, Akihiro Sato, Megumi Shimizu, Masataka Sumiyoshi, Chien-Chang Lee, Masaru Hiki, Kenji Inoue, Hiroshi Tanaka, Manabu Sugita, Yohei Hirano, Shohei Ouchi, Kentaro Fukuda, Hiroshi Tamura, Yasumasa Fujiwara, Hiroyuki Daida |
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| Rok vydání: | 2020 |
| Předmět: |
Chest Pain
medicine.medical_specialty Cardiac troponin Cardiology Prevalence 030204 cardiovascular system & hematology Chest pain Cohort Studies 03 medical and health sciences 0302 clinical medicine Troponin T Internal medicine medicine Acute chest pain Humans In patient Prospective Studies 030212 general & internal medicine Myocardial infarction business.industry Emergency department medicine.disease medicine.symptom Emergency Service Hospital Cardiology and Cardiovascular Medicine business Algorithm Algorithms Biomarkers Cohort study |
| Zdroj: | International Journal of Cardiology. 320:1-6 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2020.07.037 |
| Popis: | Background The European Society of Cardiology (ESC) recommends a 0-h/1-h (0/1-h) algorithm to classify patients with suspected non-ST-segment elevation myocardial infarction (NSTEMI). However, reliable evidence about patients who present early after the onset of symptoms is limited, likely because high-sensitivity cardiac troponin (hs-cTn) values cannot increase sufficiently within that time. This study aimed to evaluate the outcomes in real-world situations that utilized the 0/1-h algorithm. Methods In a prospective, international, multicenter cohort study that enrolled 1638 patients presenting with acute chest pain to the emergency department, we assessed the performance of the 0/1-h algorithm using hs-cTnT and the associated 30-day rates of major adverse cardiac events: death and acute myocardial infarction (AMI). Results Among 1074 patients, the prevalence of AMI was 16.0%. An approximately 60.1% (n = 645) of patients visited the hospital within 3 h after onset of chest pain (less than 1 h; 18.2% [n = 196], less than 2 h; 27.5% [n = 295], and less than 3 h; 14.3% [n = 154]). Moreover, the prevalence rates of AMI were similar at all times (1 h, 16.8%; 1–2 h, 20.7%; 2–3 h, 18.2%; p = .5). According to the ESC 0/1-h algorithm, the distribution patterns of rule-out, observe, and rule-in groups were similar; however, none of the patients was diagnosed with AMI or cardiac death in the rule-out group. Conclusion This study revealed the applicability of the 0/1-h algorithm for the management of early presenters. |
| Databáze: | OpenAIRE |
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