{"id":629,"date":"2019-02-07T18:54:29","date_gmt":"2019-02-07T18:54:29","guid":{"rendered":"http:\/\/clinicalbiochemistry.net\/?page_id=629"},"modified":"2019-02-07T18:54:30","modified_gmt":"2019-02-07T18:54:30","slug":"risk-factors-and-ami","status":"publish","type":"page","link":"http:\/\/clinicalbiochemistry.net\/?page_id=629","title":{"rendered":"Risk Factors and AMI"},"content":{"rendered":"\n

Body, R., McDowell, G.,<\/strong>Carley, S. & Mackway-Jones, K. (2008) \u2018Do risk factors for chronic coronary heart disease help diagnose acute myocardial infarction in the emergency department.\u2019 Resuscitation<\/em>79 pp. 41-45. <\/p>\n\n\n\n

Background:<\/strong>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>\n\n\n\n

Methods:<\/strong>We performed a prospective diagnostic cohort study within the ED at Manchester Royal Infirmary, a university-affiliated teaching hospital with an annual ED census of approximately 145,000 patients. We recruited 804 patients who had presented to the ED with suspected cardiac chest pain. All patients had the presence or absence of traditional cardiac risk factors documented at the time of presentation using a custom-designed clinical report form. All patients subsequently underwent 12-h troponin T testing to provide a robust gold standard for the diagnosis of AMI according to revised World Health Organisation criteria. <\/p>\n\n\n\n

Results:<\/strong>The absence of any traditional cardiac risk factors carried a negative likelihood ratio of 0.61 for the diagnosis of AMI. 12.2% of patients with no cardiac risk factors had AMI, compared with 21.3% of patients with four or five risk factors. The area under the receiver-operating characteristic curve was 0.49. <\/p>\n\n\n\n

Conclusions:<\/strong>Traditional cardiac risk factors are not helpful for the confirmation or exclusion of AMI within the ED. Future Emergency Medicine research should focus on those clinical and diagnostic features that are likely to alter during the acute phase of illness.<\/p>\n\n\nLink to Journal<\/span><\/a>","protected":false},"excerpt":{"rendered":"

Body, R., McDowell, G.,Carley, S. & Mackway-Jones, K. (2008) \u2018Do risk factors for chronic coronary heart disease help diagnose acute myocardial infarction in the emergency department.\u2019 Resuscitation79 pp. 41-45.  Background:Hypertension, hyperlipidaemia, diabetes mellitus, tobacco smoking and a family history of premature coronary<\/p>\n","protected":false},"author":1,"featured_media":598,"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-a9","jetpack-related-posts":[{"id":650,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=650","url_meta":{"origin":629,"position":0},"title":"Modified TIMI Score","date":"February 7, 2019","format":false,"excerpt":"Body, R., Carley, S.,\u00a0McDowell, G.\u00a0& Mackway-Jones. K. (2009) \u2018Can a modified TIMI risk score help to guide patient disposition.\u2019\u00a0Emerg Med J26 pp. 95-99.\u00a0 Background: 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\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2019\/01\/Modified-TIMI-1-e1549807787719.png?fit=400%2C315&resize=350%2C200","width":350,"height":200},"classes":[]},{"id":659,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=659","url_meta":{"origin":629,"position":1},"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":637,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=637","url_meta":{"origin":629,"position":2},"title":"Symptoms and Signs in ACS","date":"February 7, 2019","format":false,"excerpt":"Body, R., Carley, S., Wibberley, C.,\u00a0McDowell, G., Ferguson, J. & Mackway- Jones, K. (2010) \u2018The value of symptoms and signs in the emergent diagnosis of acute coronary syndromes.\u2019\u00a0Resuscitation81 pp. 281-286.\u00a0 Objective:Patient history and physical examination are widely accepted as cornerstones of diagnosis in modern medicine. We aimed to assess the\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2019\/01\/Symptoms-and-Signs-e1549807905811.png?fit=400%2C311&resize=350%2C200","width":350,"height":200},"classes":[]},{"id":506,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=506","url_meta":{"origin":629,"position":3},"title":"Beside Evaluation of Troponin (BEST) Study","date":"January 1, 2019","format":false,"excerpt":"The BEST Study aims to determine whether troponin testing using \u00a0point of care can accurately diagnose acute myocardial infarction (AMI) in the Emergency Department. Approximately 3% of patients who attend an Emergency Department have chest pain that the clinician who treats them initially suspects may have been caused by an\u2026","rel":"","context":"Similar post","img":{"alt_text":"","src":"https:\/\/i0.wp.com\/clinicalbiochemistry.net\/wp-content\/uploads\/2017\/12\/Cardiac-Marker-Test-Pages-1.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":136,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=136","url_meta":{"origin":629,"position":4},"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":549,"url":"http:\/\/clinicalbiochemistry.net\/?page_id=549","url_meta":{"origin":629,"position":5},"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":[]}],"_links":{"self":[{"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/pages\/629"}],"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=629"}],"version-history":[{"count":2,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/pages\/629\/revisions"}],"predecessor-version":[{"id":631,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/pages\/629\/revisions\/631"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=\/wp\/v2\/media\/598"}],"wp:attachment":[{"href":"http:\/\/clinicalbiochemistry.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=629"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}