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Pragmatic approach to chest pain patients discharged with undetectable high-sensitivity troponin T and normal electrocardiogram: the STABS + CT protocol

Bishop, W and Girao, G 2017 , 'Pragmatic approach to chest pain patients discharged with undetectable high-sensitivity troponin T and normal electrocardiogram: the STABS + CT protocol' , Internal Medicine Journal, vol. 47, no. 6 , pp. 698-701 , doi: 10.1111/imj.13443.

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Abstract

A strategy that discharges chest pain patients with negative high-sensitivity troponin and non-ischaemic electrocardiography changes may still result in 0.44% of patients experiencing myocardial infarction within 30 days. We observed that a pragmatic approach that systematically discharged 25 patients on cardio-protective medications of aspirin, metoprolol and atorvastatin followed with prompt (< 10 days) coronary computed tomography angiography resulted in no major adverse cardiac event and adverse drug reaction 30 days post-presentation. The strategy resulted in three patients (12%) ultimately diagnosed with likely unstable angina, which required planned coronary intervention in two patients and medical management in one patient. No unplanned readmissions for chest pains were noted from initial presentation through to 6-month follow up.

Item Type: Article
Authors/Creators:Bishop, W and Girao, G
Keywords: acute coronary syndrome, chest pain, coronary computed tomography angiography, high-sensitivity troponin
Journal or Publication Title: Internal Medicine Journal
Publisher: Blackwell Publishing Asia
ISSN: 1444-0903
DOI / ID Number: 10.1111/imj.13443
Copyright Information:

Copyright 2017 Royal Australasian College of Physicians

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