Outcomes in patients with chest pain in emergency departments using high-sensitivity versus conventional troponins.

There is a paucity of data regarding the association between the use of high-sensitivity troponin (hs-cTn) compared with conventional troponin (cTn) and outcomes in chest pain patients in emergency departments (EDs). This study examined the impact of hs-cTnT on prognosis in chest pain patients in EDs. In an observational cohort study, we included chest pain patients visiting the EDs of 14 hospitals in Sweden from 2011 to 2016.

Stable High-Sensitivity Cardiac Troponin T Levels and Outcomes in Patients With Chest Pain.

Background: There is a paucity of data on the association between high-sensitivity cardiac troponin (hs-cTn) levels and outcomes in patients with chest pain but no myocardial infarction (MI), or any other condition that may lead to acutely elevated troponin levels.

Objectives: The authors hypothesized that any detectable high-sensitivity cardiac troponin T (hs-cTnT) level is associated with adverse outcomes.

Methods: All patients (N = 22,589) >25 years of age with chest pain and hs-cTnT analyzed concurrently in the emergency department of Karolinska University Hospital, Stockholm, Sweden from 2011 to 2014 were eligible for inclusion.

Survival and resource utilization in patients with chest pain evaluated with cardiac troponin T compared with high-sensitivity cardiac troponin T.

Background: It is uncertain how the implementation of high-sensitivity cardiac troponin T (hs-cTnT) has affected the survival of patients with chest pain in the emergency department (ED). We studied prognosis and resource utilization in terms of coronary angiographies and revascularizations (percutaneous coronary intervention or coronary artery bypass grafting) in patients evaluated with hs-cTnT compared with conventional troponin T (cTnT).

Methods: All patients >25years presenting with chest pain and at least one troponin level analyzed in the ED at the Karolinska University Hospital, Sweden, were included.

Trends in admissions for chest pain after the introduction of high-sensitivity cardiac troponin T.

Background: The aim was to describe temporal trends in admission rates for chest pain and patient outcomes after the clinical introduction of the high-sensitivity cardiac troponin T (hs-cTnT) assay.

Methods: We included all patients aged >25years presenting with chest pain to the emergency department (ED) at our hospital during 2011-2014. For each year, rates of admissions, coronary angiographies, and revascularizations were determined.

High-sensitivity cardiac troponin T levels in the emergency department in patients with chest pain but no myocardial infarction.

Background: High-sensitivity cardiac troponin T (hs-cTnT) was recently introduced into clinical practice. The increased sensitivity has decreased the specificity. We aimed to determine the predictors for and prevalence of hs-cTnT levels above the 99th percentile in a stable population of patients without myocardial infarction (MI) who sought medical attention for chest pain in the emergency department.

Risk of revisits to the emergency department in admitted versus discharged patients with chest pain but without myocardial infarction in relation to high-sensitivity cardiac troponin T levels.

Background: Recent studies have indicated that it may be safe to discharge chest pain patients with an initial high-sensitivity cardiac troponin T (hs-cTnT) level of <5 ng/L from the emergency department (ED) without further evaluation. We sought to assess the effects of discharge from the ED versus admission to hospital on downstream resource utilisation in low-risk chest pain patients.

Methods: We included all patients who sought medical attention for chest pain during 2 years at the Karolinska University Hospital and who had no myocardial infarction (MI).

Undetectable high-sensitivity cardiac troponin T level in the emergency department and risk of myocardial infarction.

Objectives: This study sought to evaluate if an undetectable (<5 ng/l) high-sensitivity cardiac troponin T (hs-cTnT) level and an electrocardiogram (ECG) without signs of ischemia can rule out myocardial infarction (MI) in the emergency department (ED).

Background: Chest pain is a common symptom often associated with benign conditions, but may be a sign of MI. Because there is no rapid way to rule out MI, many patients are admitted to the hospital.