دورية أكاديمية
The new Vancouver Chest Pain Rule using troponin as the only biomarker: An external validation study
| العنوان: | The new Vancouver Chest Pain Rule using troponin as the only biomarker: An external validation study |
|---|---|
| المؤلفون: | Cullen, Louise, Greenslade, Jaimi, Than, Martin, Brown, Anthony, Hammett, Christopher, Lamanna, Arvin, Flaws, Dylan, Chu, Kevin, Fowles, Lindsay, Parsonage, William |
| المصدر: | American Journal of Emergency Medicine |
| بيانات النشر: | W.B. Saunders Ltd |
| سنة النشر: | 2014 |
| المجموعة: | Queensland University of Technology: QUT ePrints |
| الوصف: | Objectives To externally evaluate the accuracy of the new Vancouver Chest Pain Rule and to assess the diagnostic accuracy using either sensitive or highly sensitive troponin assays. Methods Prospectively collected data from 2 emergency departments (EDs) in Australia and New Zealand were analysed. Based on the new Vancouver Chest Pain Rule, low-risk patients were identified using electrocardiogram results, cardiac history, nitrate use, age, pain characteristics and troponin results at 2 hours after presentation. The primary outcome was 30-day diagnosis of acute coronary syndrome (ACS), including acute myocardial infarction, and unstable angina. Sensitivity, specificity, positive predictive values and negative predictive values were calculated to assess the accuracy of the new Vancouver Chest Pain Rule using either sensitive or highly sensitive troponin assay results. Results Of the 1635 patients, 20.4% had an ACS diagnosis at 30 days. Using the highly sensitive troponin assay, 212 (13.0%) patients were eligible for early discharge with 3 patients (1.4%) diagnosed with ACS. Sensitivity was 99.1% (95% CI 97.4-99.7), specificity was 16.1 (95% CI 14.2-18.2), positive predictive values was 23.3 (95% CI 21.1-25.5) and negative predictive values was 98.6 (95% CI 95.9-99.5). The diagnostic accuracy of the rule was similar using the sensitive troponin assay. Conclusions The new Vancouver Chest Pain Rule should be used for the identification of low risk patients presenting to EDs with symptoms of possible ACS, and will reduce the proportion of patients requiring lengthy assessment; however we recommend further outpatient investigation for coronary artery disease in patients identified as low risk. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| العلاقة: | Cullen, Louise, Greenslade, Jaimi, Than, Martin, Brown, Anthony, Hammett, Christopher, Lamanna, Arvin, Flaws, Dylan, Chu, Kevin, Fowles, Lindsay, & Parsonage, William (2014) The new Vancouver Chest Pain Rule using troponin as the only biomarker: An external validation study. American Journal of Emergency Medicine, 32(2), pp. 129-134.; https://eprints.qut.edu.au/88614Test/; Faculty of Health; Centre for Health Research |
| الإتاحة: | https://doi.org/10.1016/j.ajem.2013.10.021Test https://eprints.qut.edu.au/88614Test/ |
| حقوق: | Consult author(s) regarding copyright matters ; This work is covered by copyright. Unless the document is being made available under a Creative Commons Licence, you must assume that re-use is limited to personal use and that permission from the copyright owner must be obtained for all other uses. If the document is available under a Creative Commons License (or other specified license) then refer to the Licence for details of permitted re-use. It is a condition of access that users recognise and abide by the legal requirements associated with these rights. If you believe that this work infringes copyright please provide details by email to qut.copyright@qut.edu.au |
| رقم الانضمام: | edsbas.A8BA128F |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |