Validation of the American College of Cardiology (ACC) Expert Consensus Decision Pathway for Patients With Chest Pain
Authors' conclusion
The ACC expert consensus decision pathway was safe and efficacious. However, it may not be safe for use among patients with known CAD.
Study context
- Population
- Adults with possible ACS presenting to 5 US EDs, November 1, 2020, to July 31, 2022
- Participants
- 14,395 adults
- Outcome
- All-cause death or MI (primary safety outcome); efficacy = proportion stratified to rule-out zone
- Follow-up
- 30 days
Methodological detailsmulticentre, 5 US EDs
- Multicentre
- 5 US EDs
Main finding
As reported in the abstract
| Group | Efficacy (ruled out) | Death or myocardial infarction (MI) in rule-out zone | NPV |
|---|---|---|---|
| ACC Pathway | 48.1% (95% CI: 47.3%-49.0%) | 0.3% (22 of 6,930) | 99.7% (95% CI: 99.5%-99.8%) |
ACC Pathway
Efficacy (ruled out)48.1% (95% CI: 47.3%-49.0%)
Death or myocardial infarction (MI) in rule-out zone0.3% (22 of 6,930)
NPV99.7% (95% CI: 99.5%-99.8%)
Observational data: associations, not effects.
Further findings
Rule-out zone and 30-day death or MI in known coronary artery disease (CAD) (subgroup)
- Classified to rule-out zone
- 20.0% (676 of 3,386)
- Death or MI among rule-out
- 1.5% (10 of 676)
Original publication
Validation of the ACC Expert Consensus Decision Pathway for Patients With Chest Pain. J Am Coll Cardiol. Published 25 March 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →