Publications by authors named "J Tobias Nagurney"
Agreement among high-sensitivity cardiac troponin assays and non-invasive testing, clinical outcomes, and quality-of-care outcomes based on the 2020 European Society of Cardiology Guidelines.
Eur Heart J Acute Cardiovasc Care
February 2024
Article Synopsis
- The study aimed to analyze how different high-sensitivity cardiac troponin (hs-cTn) assays impact the risk stratification and management of patients suspected of having acute coronary syndrome (ACS) based on the 2020 European Society of Cardiology guidelines.
- Blood samples from 238 patients were tested using four different hs-cTn assays, and results showed a 74% overall concordance in classifying patients, with significant variations in rule-out and observe strata but not in rule-in strata.
- Findings revealed that management decisions and quality of care varied significantly among assays, suggesting that patient outcomes could be influenced by the specific assay used, indicating a need for more research to standardize practices.
Background: Among persons presenting to the emergency department with suspected acute myocardial infarction (MI), cardiac troponin (cTn) testing is commonly used to detect acute myocardial injury. Accelerated diagnostic protocols (ADPs) guide clinicians to integrate cTn results with other clinical information to decide whether to order further diagnostic testing.
Objective: To determine the change in the rate and yield of stress test or coronary CT angiogram following cTn measurement in patients with chest pain presenting to the emergency department pre- and post-transition to a high-sensitivity (hs-cTn) assay in an updated ADP.
Background Patients presenting to the emergency department (ED) with acute chest pain (ACP) syndrome undergo additional testing to exclude acute coronary syndrome (ACS), pulmonary embolism (PE), or aortic dissection (AD), often yielding negative results. Purpose To assess whether deep learning (DL) analysis of the initial chest radiograph may help triage patients with ACP syndrome more efficiently. Materials and Methods This retrospective study used electronic health records of patients with ACP syndrome at presentation who underwent a combination of chest radiography and additional cardiovascular or pulmonary imaging or stress tests at two hospitals (Massachusetts General Hospital [MGH], Brigham and Women's Hospital [BWH]) between January 2005 and December 2015.
View Article and Find Full Text PDFBackground: Although primary percutaneous coronary intervention (pPCI) is the preferred intervention for ST-elevation myocardial infarction (STEMI), not all patients are admitted directly to an emergency department (ED) with 24/7/365 pPCI capabilities. This is partly due to a lack of a national system of known pPCI-capable EDs. Our objective was to create a unified, national database of confirmed 24/7/365 pPCI centers co-located in hospitals with EDs.
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