Clinical Outcomes for Chest Pain Patients Discharged Home from Emergency Departments Utilizing High-Sensitivity vs. Conventional Cardiac Troponin Assays

Publication date: Available online 11 December 2019Source: American Heart JournalAuthor(s): Geoffrey Lau, Maria Koh, Peter A. Kavsak, Michael J. Schull, David W.J. Armstrong, Jacob A. Udell, Peter C. Austin, Xuesong Wang, Dennis T. KoABSTRACTBackgroundHigh-sensitivity cardiac troponin (hs-cTn) assays enhance detection of lower circulating troponin concentrations, but the impact on outcomes in clinical practice is unclear. Our objective was to compare outcomes of chest pain patients discharged from emergency departments (EDs) using hs-cTn and conventional troponin (cTn) assays.MethodsWe conducted an observational study of chest pain patients aged 40–105 years who presented to an ED from April 1st 2013 to March 31st 2017, and were discharged home. We compared 30-day and 1-year outcomes of EDs that utilized hs-cTn vs. cTn assays. The primary outcome was a composite of all-cause death, MI or unstable angina. Comparisons were conducted with i) no adjustment; ii) adjustment for demographic, socioeconomic, and hospital characteristics; and iii) full clinical adjustment.ResultsAmong the 394,910 patients, 62,138 (15.7%) were evaluated at hs-cTn EDs and 332,772 (84.3%) were evaluated at cTn EDs. Patients discharged from hs-cTn EDs were less likely to have diabetes, hypertension, or prior heart disease. At 30-days, the unadjusted primary outcome rate was lower in hs-cTn EDs (0.9% vs. 1.0%, P 
Source: American Heart Journal - Category: Cardiology Source Type: research

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Publication date: March 2020Source: American Heart Journal, Volume 221Author(s): Geoffrey Lau, Maria Koh, Peter A. Kavsak, Michael J. Schull, David W.J. Armstrong, Jacob A. Udell, Peter C. Austin, Xuesong Wang, Dennis T. KoBackgroundHigh-sensitivity cardiac troponin (hs-cTn) assays enhance detection of lower circulating troponin concentrations, but the impact on outcomes in clinical practice is unclear. Our objective was to compare outcomes of chest pain patients discharged from emergency departments (EDs) using hs-cTn and conventional troponin (cTn) assays.MethodsWe conducted an observational study of chest pain patients ...
Source: American Heart Journal - Category: Cardiology Source Type: research
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Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
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