Related Experiment Video

Updated: Feb 21, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

24.8K

Early Exclusion of Major Adverse Cardiac Events in Emergency Department Chest Pain Patients: A Prospective

Yuk-Ki Leung1, Nga-Man Cheng1, Cangel Pui-Yee Chan1

  • 1Accident and Emergency Medicine Academic Unit, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.

The Journal of Emergency Medicine
|October 11, 2017
PubMed

Insights

A modified TIMI score of 0 or HEART score of ≤ 2 effectively identifies low-risk patients for early discharge. These scores, using a single cardiac troponin T measurement, rule out major adverse cardiac events within 30 days.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Biomarker Research

Background:

  • Evaluating chest pain in the emergency department (ED) for acute coronary syndrome (ACS) is often prolonged.
  • Current protocols rely on serial troponin measurements, increasing ED wait times.

Purpose of the Study:

  • To validate the diagnostic accuracy of the Thrombolysis in Myocardial Infarction (TIMI) score with a single high-sensitive cardiac troponin T (hs-cTnT) measurement.
  • To compare the TIMI score's effectiveness against combinations of heart-type fatty acid binding protein (H-FABP) and a modified HEART score for ruling out 30-day major adverse cardiac events (MACE).

Main Methods:

  • Recruited 602 adult patients presenting to the ED with chest pain and suspected ACS.
  • Assessed TIMI and HEART scores, and performed point-of-care H-FABP testing for each patient.

Main Results:

  • A modified TIMI score of 0 (11% of patients) and a HEART score ≤ 2 (16% of patients) identified individuals with no 30-day MACE, achieving 100% sensitivity.
  • Combining TIMI and HEART scores enhanced specificity to 22.0% without compromising sensitivity.
  • Early H-FABP measurement (> 7 μg/L) showed 91.1% specificity for predicting 30-day MACE.

Conclusions:

  • A modified TIMI score of 0 or a HEART score of ≤ 2, utilizing a single hs-cTnT level, can reliably identify low-risk patients.
  • These scores facilitate early discharge from the ED within 2 hours for patients with low risk of 30-day MACE.
Abstract

Keywords:
acute coronary syndromechest paindiagnosismajor adverse cardiac event

More Related Videos

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

981
Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

4.6K

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
316
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
1.7K
Imaging Studies for Cardiovascular System I:Echocardiography01:17

Imaging Studies for Cardiovascular System I:Echocardiography

Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
795
Introduction Cardiac Emergencies01:30

Introduction Cardiac Emergencies

Cardiac emergencies are critical situations involving the heart that require immediate medical intervention to prevent severe complications or death. These emergencies often arise from underlying heart conditions that impair the heart's ability to function correctly.Types of Cardiac EmergenciesThe most common types of cardiac emergencies include Acute Coronary Syndrome (ACS), myocardial infarction (MI), cardiac arrest, and heart failure.Acute Coronary Syndrome (ACS)Acute Coronary Syndrome (ACS)...
421
Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
287
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
1.2K