{"id":531,"date":"2019-01-19T09:52:36","date_gmt":"2019-01-19T09:52:36","guid":{"rendered":"http:\/\/clinicalbiochemistry.net\/?page_id=531"},"modified":"2019-01-19T09:52:38","modified_gmt":"2019-01-19T09:52:38","slug":"manchester-acute-coronary-syndrome-rule-macs-t-macs","status":"publish","type":"page","link":"http:\/\/clinicalbiochemistry.net\/?page_id=531","title":{"rendered":"Manchester Acute Coronary Syndrome Rule (MACS &#038; T-MACS)"},"content":{"rendered":"\n<ul data-carousel-extra='{\"blog_id\":1,\"permalink\":\"http:\\\/\\\/clinicalbiochemistry.net\\\/?page_id=531\"}'  class=\"wp-container-2 wp-block-gallery-1 wp-block-gallery columns-3 is-cropped\"><li class=\"blocks-gallery-item\"><figure><img data-attachment-id=\"183\" data-permalink=\"http:\/\/clinicalbiochemistry.net\/?attachment_id=183\" data-orig-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Research-Papers-Pages-1.png?fit=200%2C133\" data-orig-size=\"200,133\" data-comments-opened=\"0\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Research Papers -Pages\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Clinical Evaluation&lt;\/p&gt;\n\" data-medium-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Research-Papers-Pages-1.png?fit=200%2C133\" data-large-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Research-Papers-Pages-1.png?fit=200%2C133\" loading=\"lazy\" width=\"200\" height=\"133\" src=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Research-Papers-Pages-1.png?resize=200%2C133\" alt=\"\" data-id=\"183\" data-link=\"http:\/\/clinicalbiochemistry.net\/?attachment_id=183\" class=\"wp-image-183\" data-recalc-dims=\"1\"\/><figcaption>Clinical Evaluation<\/figcaption><\/figure><\/li><li class=\"blocks-gallery-item\"><figure><img data-attachment-id=\"161\" data-permalink=\"http:\/\/clinicalbiochemistry.net\/?attachment_id=161\" data-orig-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/ECG-Featured.png?fit=200%2C134\" data-orig-size=\"200,134\" data-comments-opened=\"0\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"ECG Featured\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Clinical Data&lt;\/p&gt;\n\" data-medium-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/ECG-Featured.png?fit=200%2C134\" data-large-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/ECG-Featured.png?fit=200%2C134\" loading=\"lazy\" width=\"200\" height=\"134\" src=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/ECG-Featured.png?resize=200%2C134\" alt=\"\" data-id=\"161\" data-link=\"http:\/\/clinicalbiochemistry.net\/?attachment_id=161\" class=\"wp-image-161\" data-recalc-dims=\"1\"\/><figcaption>Clinical Data<\/figcaption><\/figure><\/li><li class=\"blocks-gallery-item\"><figure><img data-attachment-id=\"153\" data-permalink=\"http:\/\/clinicalbiochemistry.net\/?attachment_id=153\" data-orig-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Cardiac-Marker-Test-Faetured.png?fit=200%2C133\" data-orig-size=\"200,133\" data-comments-opened=\"0\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Cardiac Marker Test &#8211; Faetured\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Biomarker Development and Validation&lt;\/p&gt;\n\" data-medium-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Cardiac-Marker-Test-Faetured.png?fit=200%2C133\" data-large-file=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Cardiac-Marker-Test-Faetured.png?fit=200%2C133\" loading=\"lazy\" width=\"200\" height=\"133\" src=\"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Cardiac-Marker-Test-Faetured.png?resize=200%2C133\" alt=\"\" data-id=\"153\" data-link=\"http:\/\/clinicalbiochemistry.net\/?attachment_id=153\" class=\"wp-image-153\" data-recalc-dims=\"1\"\/><figcaption>Biomarker Development and Validation<\/figcaption><\/figure><\/li><\/ul>\n\n\n\n<p>Current diagnostic methods for acute coronary syndromes lack sensitivity and specificity at the time of presentation to the Emergency Department. <\/p>\n\n\n\n<p>The MACS and T-MACS rule has been developed using information available at the time of first presentation and the results from a single blood test for cardiac troponin. Initial evaluation demonstrated that the MACS rule could enable safe discharge of around a quarter of patients. The MACS rule also enabled he identification of high risk patients, facilitating a stratified approach to patient management.<\/p>\n\n\n\n<p>The rule has been further refined and validated using point of care troponin testing as part of the Beside Evaluation of Troponin (BEST) Study<\/p>\n\n\n\n<h2>MACS and T-MACS Publications<\/h2>\n\n\n\n\t<div class=\"wppap-main-wrapper wpapap-clearfix\">\n\t\t<ul id=\"thumbs-1\" class=\"wppap-thumbs\" data-conf=\"{&quot;grid&quot;:3}\">\n\t\t\t\t<li class=\"thum-list\">\n\t\t\t\t\t<a data-mfp-src=\"#thumb1\" href=\"#\" class=\"wppap-thumbnail\" style=\"background-image: url('http:\/\/clinicalbiochemistry.net\/wp-content\/uploads\/2019\/01\/MACS-Paper-e1549807711724.png')\">\n\t\t\t\t\t\t<span class=\"wppap-description\">MACS Rule<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/li>\n\t\t\t\n\t\t\t\t<li class=\"thum-list\">\n\t\t\t\t\t<a data-mfp-src=\"#thumb2\" href=\"#\" class=\"wppap-thumbnail\" style=\"background-image: url('http:\/\/clinicalbiochemistry.net\/wp-content\/uploads\/2019\/01\/T-MACS-and-POCT-e1549808066171.png')\">\n\t\t\t\t\t\t<span class=\"wppap-description\">POCT &#038; T-MACS<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/li>\n\t\t\t\n\t\t\t\t<li class=\"thum-list\">\n\t\t\t\t\t<a data-mfp-src=\"#thumb3\" href=\"#\" class=\"wppap-thumbnail\" style=\"background-image: url('http:\/\/clinicalbiochemistry.net\/wp-content\/uploads\/2019\/01\/T-MACS-e1549808380580.png')\">\n\t\t\t\t\t\t<span class=\"wppap-description\">T- MACS Rule<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/li>\n\t\t\t\t\t<\/ul>\n\n\t\t<div class=\"wppap-portfolio-content\">\n\n\t\t\t\n\t\t\t\t<div id=\"thumb1\">\n\n\t\t\t\t\t\t\t\t\t\t<div class=\"wppap-medium-12 wppap-columns wppap-right-column\">\n\t\t\t\t\t\t<div class=\"wppap-right-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wppap-title\">MACS Rule<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wppap-content\"><p><span lang=\"EN-US\">We aimed to derive and validate a clinical decision rule (CDR) for suspected cardiac chest pain in the emergency department (ED). Incorporating information available at the time of first presentation, this CDR would effectively risk-stratify patients and immediately identify: (A) patients for whom hospitalisation may be safely avoided; and (B) high-risk patients, facilitating judicious use of resources.<\/span><\/p>\n<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/clinicalbiochemistry.net\/?page_id=659\" class=\"wppap-project-url-btn\" target=\"_blank\">View Project<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t \n\t\t\t\t<div id=\"thumb2\">\n\n\t\t\t\t\t\t\t\t\t\t<div class=\"wppap-medium-12 wppap-columns wppap-right-column\">\n\t\t\t\t\t\t<div class=\"wppap-right-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wppap-title\">POCT &#038; T-MACS<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wppap-content\"><p>The rapid turnaround time of point of care (POC) cardiac troponin (cTn) assays is highly attractive for crowded Emergency Departments (EDs). We evaluated the diagnostic accuracy of the Troponin-only Manchester Acute Coronary Syndromes (T-MACS) decision aid with a POC cTn assay.<\/p>\n<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/clinicalbiochemistry.net\/?page_id=568\" class=\"wppap-project-url-btn\" target=\"_blank\">View Project<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t \n\t\t\t\t<div id=\"thumb3\">\n\n\t\t\t\t\t\t\t\t\t\t<div class=\"wppap-medium-12 wppap-columns wppap-right-column\">\n\t\t\t\t\t\t<div class=\"wppap-right-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wppap-title\">T- MACS Rule<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wppap-content\"><p>Body, R., Carlton, E., Sperrin, M., Lewis, P.S., Burrows, G., Carley, S., <strong>McDowell, G<\/strong>., Buchan, I., Greaves, K. &amp; Mackway-Jones, K. (2017). Troponin only Manchester Acute Coronary Syndromes (T-MACS) decision aid: single biomarker re-derivation and external validation in three cohorts. Emerg Med J 34 pp. 349-356<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Background<\/strong><\/p>\n<p>The original Manchester Acute Coronary Syndromes model (MACS) \u2018rules in\u2019 and \u2018out\u2019 acute coronary syndromes (ACS) using high sensitivity cardiac troponin T (hs-cTnT) and heart-type fatty acid binding protein (H-FABP) measured at admission. The latter is not always available. We aimed to refine and validate MACS as T-MACS, cutting down the biomarkers to just hs-cTnT.<\/p>\n<p>&nbsp;<\/p>\n<p>[maxbutton id=\"1\" ]<\/p>\n<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/clinicalbiochemistry.net\/?page_id=136\" class=\"wppap-project-url-btn\" target=\"_blank\">View Project<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t \t\t<\/div>\n\t<\/div>\n\t\n","protected":false},"excerpt":{"rendered":"<p>Current diagnostic methods for acute coronary syndromes lack sensitivity and specificity at the time of presentation to the Emergency Department. The MACS and T-MACS rule has been developed using information available at the time of first presentation and the results<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"jetpack_post_was_ever_published":false,"_links_to":"","_links_to_target":""},"jetpack_shortlink":"https:\/\/wp.me\/P9tPlw-8z","jetpack-related-posts":[{"id":136,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=136","url_meta":{"origin":531,"position":0},"title":"T-MACS","date":"December 22, 2017","format":false,"excerpt":"Body, R., Carlton, E., Sperrin, M., Lewis, P.S., Burrows, G., Carley, S., McDowell, G., Buchan, I., Greaves, K. & Mackway-Jones, K. (2017). Troponin only Manchester Acute Coronary Syndromes (T-MACS) decision aid: single biomarker re-derivation and external validation in three cohorts. Emerg Med J 34 pp. 349-356 Background The original Manchester\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Cardiac-Marker-Test-Pages-300x200.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":568,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=568","url_meta":{"origin":531,"position":1},"title":"T-MACS and POCT Troponin","date":"January 17, 2019","format":false,"excerpt":"The Troponin-only Manchester Acute Coronary Syndromes (T-MACS) decision aid for rapid rule-in and rule-out of acute coronary syndromes using a contemporary point of care troponin assay Richard Body; Malak Almashali; Niall Morris; Phil Moss; Heather Jarman; Andrew Appelboam; Richard Parris; Louisa Chan; Alison Walker; Mark Harrison; Andrea Wootten; Garry McDowellc\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":659,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=659","url_meta":{"origin":531,"position":2},"title":"MACS Rule","date":"February 7, 2019","format":false,"excerpt":"Body, R., Carley, S.,\u00a0McDowell, G., Pemberton, P., Burrows, G., Cook, G., Lewis, P.S., Smith, A., Mackway-Jones, K. (2014) \u2018The Manchester Acute Coronary Syndromes (MACS) decision rule for suspected cardiac chest pain: derivation and external validation.\u2019 Heart 100 pp. 1462-1468.\u00a0 Objective:We aimed to derive and validate a clinical decision rule (CDR)\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2019\/01\/MACS-Paper-e1549807711724.png?fit=400%2C331&resize=350%2C200","width":350,"height":200},"classes":[]},{"id":549,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=549","url_meta":{"origin":531,"position":3},"title":"PhD Project: BEST Study","date":"January 11, 2019","format":false,"excerpt":"Expediting the confirmation of acute myocardial infarction with point of care troponin and heart fatty acid binding protein testing to facilitate early intervention in emergency department Cardiac troponin is the reference standard biomarker for the diagnosis of acute myocardial infarction (AMI). In the appropriate clinical context, the detection of a\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":121,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=121","url_meta":{"origin":531,"position":4},"title":"Research Papers","date":"December 22, 2017","format":false,"excerpt":"Body, R., McDowell, G., Carley, S., Ferguson, J. & Mackway-Jones, K. (2010) \u2018Diagnosing acute myocardial infarction with troponins: how low can you go?\u2019 Emerg Med J. 27 pp. 292-296. Body, R., Carley, S., Wibberley, C., McDowell, G., Ferguson, J. & Mackway- Jones, K. (2010) \u2018The value of symptoms and signs\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]}],"_links":{"self":[{"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/pages\/531"}],"collection":[{"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=531"}],"version-history":[{"count":3,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/pages\/531\/revisions"}],"predecessor-version":[{"id":588,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/pages\/531\/revisions\/588"}],"wp:attachment":[{"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=531"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}