Early Vascular Markers of Acute Coronary Syndromes.
Purpose: To study the utility of incorporating early vascular activation markers into a clinical decision rule to risk stratify patients according to their risk of a significant myocardial event.
Methods: We recruited a cohort of patients with symptoms suggest of ACS presenting to the emergency department. Blood was obtained to determine if early markers of vascular activation can be combined with clinical findings to create a clinical decision rule capable of the early risk stratification of patients with ACS. The presence of ACS will be determined by Troponin estimation and clinical follow up.
Study Outcome: A combined clinical and biochemical clinical decision rule to risk stratify patients with symptoms suggest of ACS in the emergency setting.
Early Vascular Markers of Acute Coronary Syndromes Study Publications
The authors compared the prognostic implications of placing the diagnostic troponin cut-off at the 99th percentile and at the lowest concentration with a CV <10% (functional sensitivity).
The thrombolysis in myocardial infarction (TIMI) risk score has been shown to risk stratify patients with suspected acute coronary syndromes (ACS) effectively in the emergency department (ED) but cannot be used to guide patient disposition. We aimed to evaluate whether modifying the TIMI risk score to give greater weighting to ischaemic ECG changes and troponin elevations would enhance its risk stratification and thus potentially facilitate safe patient discharge after 12-h troponin testing.
This paper sought to evaluate whether high sensitivity troponin (hs-cTnT) can immediately exclude acute myocardial infarction (AMI) at a novel ‘rule out’ cut-off.
Many Emergency Departments (EDs) utilise ‘triple marker’ testing with CK-MB, myoglobin and troponin I (cTnI) to exclude acute myocardial infarction (AMI) within hours of presentation. We evaluated the ability of 8 biomarkers to rapidly exclude AMI at the point of presentation and investigated whether ‘triple marker’ testing represents the optimal multimarker strategy.
Patient history and physical examination are widely accepted as cornerstones of diagnosis in modern medicine. We aimed to assess the value of individual historical and examination findings for diagnosing acute myocardial infarction (AMI) and predicting adverse cardiac events in undifferentiated Emergency Department (ED) patients with chest pain.
Hypertension, hyperlipidaemia, diabetes mellitus, tobacco smoking and a family history of premature coronary artery disease are known to be risk factors for the development of coronary artery disease. We sought to determine whether these traditional risk factors aid the diagnosis of acute myocardial infarction (AMI) in the Emergency Department (ED).
P-selectin has early diagnostic value for AMI and prognostic value independent of cTnT and ECG findings. The combination of P-selectin, cTnT and ECG has high NPV.
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