Abstract 13592: Addition of the Heart Score to a hsTnT Accelerated Diagnostic Protocol: Effect on Negative Predictive Value at Different hsTnT Thresholds

• DOI: 10.1161/circ.148.suppl_1.13592
• Publication Date: 2023-12-19T07:50:21Z
• Authors: Muzna Hussain; Ria Garg; Kyle Marshall; Martin E Matsumura
• Keywords: Mace; Cut-off; Troponin T

Background: The majority of pts with CP and low to modest elevations high sensitivity troponin (hsTn) are safe for discharge from the ED; thus improvement negative predictive value (NPV) accelerated diagnostic protocol (ADP) can have significant impact on ED throughput. Prior studies examined role adding bioclinical risk scores such as HEART score (HS) a hsTn ADP. In general these suggest HS does not add prediction 30d MACE peak levels, i.e. less that 99 th percentile. Little is known about effect ADP higher values troponin. Research question: How would addition affect NPV hsTnT across range elevations? Methods: Retrospective analysis presenting assessed validated well an EHR-embedded decision tool 5/2022-3/2023. was derived ESC guidelines were excluded if > 52ng/l (the cutoff “rule-in”). For calculation at 30 days post-discharge grouped by <6ng/l, <12ng/l, <52ng/l. < 3 (low risk) or >3 (intermediate-high risk). Comparison results performed using chi square analysis. Results: Summarized in Table. did significantly change <6ng/l <12ng/l. contrast, <52ng/l improved HS. Conclusion: additive identifying depends measurement- very levels (ie limit quantitation – approx. percentile) but improve between percentile “rule-in” our This findings should be considered when designing evaluation protocols incorporate into algorithm.