External Validation of the Manchester Acute Coronary Syndromes Decision Rule

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Edward W CarltonKim Greaves

Abstract

The Manchester Acute Coronary Syndromes (MACS) decision rule has been shown to be a powerful diagnostic tool in emergency department (ED) patients with suspected acute coronary syndromes (ACS). It has the potential to improve system efficiency by identifying patients suitable for discharge after a single blood draw for high-sensitivity troponin and heart-type fatty acid-binding protein (h-FABP) analysis at presentation to the ED. The objective was to externally validate the MACS decision rule and establish its diagnostic accuracy as a discharge tool in a new set of prospectively recruited ED patients. In this preplanned analysis of a prospectively recruited single-center cohort, consecutive ED patients ≥18 years with suspected ACS were included. Testing for h-FABP and high-sensitivity troponin T was undertaken on serum drawn on arrival, and any clinical features required to calculate the MACS rule were recorded. The primary outcome was major adverse cardiac events (MACE) within 30 days (acute myocardial infarction [AMI], death, or revascularization). The secondary outcome was AMI alone, adjudicated using 6-hour troponin results. Of the 782 participants included, 78 (10.0%) developed MACE and 61 (7.8%) had an AMI. Of participant...Continue Reading

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Apr 29, 2015·The American Journal of Medicine·Edward W CarltonKim Greaves

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Citations

May 24, 2017·European Heart Journal. Acute Cardiovascular Care·Patricia Van Den Berg, Richard Body
Jan 8, 2017·Clinical Chemistry·Louise A CullenRichard Body
Jul 23, 2020·Annals of Medicine·Harsh GoelGregory Y H Lip
Oct 15, 2020·Emergency Medicine Journal : EMJ·Steve GoodacreLynda Unitt

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