Study: Single Test Can Quickly Rule Out Myocardial Infarction

The use of a single high-sensitivity cardiac troponin T (hs-cTnT) measurement plus electrocardiogram (ECG) can rule out acute myocardial infarction (AMI) in patients presenting to the emergency department with chest pain, according to the results of a recent meta-analysis.
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The researchers conducted a meta-analysis of data from 9241 from 11 cohort studies of adults who presented to the emergency department with possible acute coronary syndrome who underwent ECG and hs-cTnT.

Overall, 2825 (30.6%) of patients were classified as low risk (having no new ischemia on ECG and hs-cTnT measurements <0.005 µg/L), of which, 14 (0.5%) had AMI. Sensitivity of the testing strategy ranged from 87.5% to 100% in the individuals studies, and the pooled estimate sensitivity was 98.7%. Overall sensitivity for major acute cardiovascular events was 98%.

“A single hs-cTnT concentration below the limit of detection in combination with a nonischemic ECG may successfully rule out AMI in patients presenting to [emergency departments] with possible emergency acute coronary syndrome.”

—Michael Potts

Reference:

Rapid rule-out of acute myocardial infarction with a single high-sensitivity cardiac troponin t measurement below the limit of detection: a collaborative meta-analysis [published online April 18, 2017]. Ann Intern Med. doi:10.7326/M16-2562.