Suspected Non-ST-elevation acute coronary syndrome meeting rapid rule-out criteria: resource utilization, diagnostic yield, and clinical outcomes of hospital admission
Authors' conclusion
In-hospital and ensuing prognosis were better with lower initial hs-cTnT values.
Study context
- Population
- Emergency department (ED) patients with suspected NSTE-ACS meeting 2020 European Society of Cardiology (ESC) rapid myocardial infarction (MI) rule-out criteria (initial hs-cTnT <5 ng/L, or ≥5 but <14 ng/L with a small increment on a subsequent test)3,775 admitted
- Participants
- 11,477 patients
- Exposure
- Admitted vs Discharged
- Admittedn = 3,775
- Outcome
- Index MI or overall death
- Follow-up
- 30 days
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Index MI or overall death (admitted patients)
Admitted
0.32%
12 of 3775
Observational data: associations, not effects.
Further findings
Revascularization among admitted patients
- Revascularization uncommon
- 2.5%
Resource utilization (ED stay, hospital stay, noninvasive and invasive tests)
- Resource utilization substantial
Survival, admitted vs discharged
- Similar survival of admitted vs discharged patients after multivariate adjustment for age, gender and baseline CV risk factors
- P = 0.88
Long-term mortality by initial hs-cTnT
- Initial hs-cTnT even below the 99th percentile provided prognostic stratification for long-term mortality
Original publication
Suspected Non-ST-elevation acute coronary syndrome meeting rapid rule-out criteria: resource utilization, diagnostic yield, and clinical outcomes of hospital admission. Eur Heart J Qual Care Clin Outcomes. Published 24 January 2023. doi:10.
Summarised from the published abstract; every number is checked against it