Consequences of different cut-off values for high-sensitivity cardiac troponin for risk stratification of patients suspected for NSTE-ACS with a modified HEART score.
Rudolf T TolsmaMarion J FokkertJan Paul OttervangerDominique N van DongenErik A BadingsAize van der SluisArnoud W J van 't HofRobbert J SlingerlandPublished in: Future cardiology (2023)
Aim: This study aims to enhance prehospital risk assessment for suspected non-ST-elevation acute coronary syndrome (NSTE-ACS) patients using the HEART-score. By incorporating novel point-of-care high-sensitivity cardiac troponin devices, a modified HEART-score was developed and compared with the conventional approach. Patients & methods: Troponin points within the modified HEART-score are based on values below the limit of quantitation (LoQ), between the LoQ and 99th percentile and above the 99th percentile of the used device. A total HEART-score of three or lower is considered low-risk for major adverse cardiac events. Results & conclusion: The number of low-risk patients decreased based on the modified HEART-score. The sensitivity and negative predictive value increased which suggests increasing safety in ruling out patients with suspected NSTE-ACS.
Keyphrases
- end stage renal disease
- acute coronary syndrome
- ejection fraction
- heart failure
- newly diagnosed
- risk assessment
- chronic kidney disease
- peritoneal dialysis
- atrial fibrillation
- emergency department
- pulmonary embolism
- coronary artery disease
- high resolution
- heavy metals
- antiplatelet therapy
- electronic health record
- high performance liquid chromatography
- simultaneous determination
- tandem mass spectrometry