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February 25, 2021
Assisted by the HEART score, emergency physicians appear to be able to safely discharge patients with chest pain after just one negative conventional troponin test result, a retrospective cohort study suggests.
The 30-day rate of acute MI or cardiac mortality was similar regardless of whether patients had one troponin test or underwent serial testing in the emergency department (0.4% in both groups), researchers report.
Clinical guidelines recommend serial troponin testing in patients presenting with symptoms indicative of ACS, but these findings suggest that a single negative test when combined with risk-stratification tools like the HEART score and a physician’s clinical judgment might be good enough, senior author Adam Sharp, MD (Kaiser Permanente Southern California, Pasadena, CA), told TCTMD.