PMID- 31542905
OWN - NLM
STAT- MEDLINE
DCOM- 20191007
LR  - 20191007
IS  - 1565-1088 (Print)
VI  - 21
IP  - 9
DP  - 2019 Sep
TI  - Low-risk Non-ST-Elevation Acute Coronary Syndrome and Normal Troponin: Do We Need 
      Further Evaluation?
PG  - 603-606
AB  - BACKGROUND: With the recent introduction of high-sensitivity troponin (hsTn), the 
      incremental benefit of stress myocardial perfusion imaging (MPI) in the 
      evaluation of patients who present to the emergency department (ED) with acute 
      coronary syndrome (ACS) is unclear. OBJECTIVES: To assess the added value of 
      stress MPI in low-risk ACS patients with normal range hsTnI. METHODS: We analyzed 
      all patients who were hospitalized at our medical center from February 2016 to 
      November 2017, who presented with low-risk ACS and underwent stress MPI, and in 
      whom hsTnI was in the normal range after the introduction of hsTnI. RESULTS: 
      During the study period, 161 patients were admitted with a diagnosis of unstable 
      angina (i.e., ACS with normal range hsTnI) and underwent stress MPI during index 
      admission. The study population included 52/161 patients (31.7%) with low-risk 
      ACS who had no indication for initial invasive strategy. No patients had positive 
      MPI. One patient underwent coronary angiography due to suggestive history; 
      however, he did not have a significant coronary artery disease and had no 
      indication for percutaneous coronary intervention. CONCLUSIONS: In patients with 
      low-risk ACS and normal range hsTnI without additional high-risk features, stress 
      MPI has little additional value for the correct diagnosis and management. 
      Prospective studies are warranted to confirm whether resting hsTnI could serve as 
      a powerful triage tool in chest pain patients in the ED before diagnostic testing 
      and thus, improve patient management.
FAU - Marcusohn, Erez
AU  - Marcusohn E
AD  - Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
FAU - Epstein, Danny
AU  - Epstein D
AD  - Department of Internal Medicine B, Rambam Health Care Campus, Haifa, Israel.
FAU - Musallam, Anees
AU  - Musallam A
AD  - Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
FAU - Keidar, Zohar
AU  - Keidar Z
AD  - Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
AD  - Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, 
      Israel.
FAU - Roguin, Ariel
AU  - Roguin A
AD  - Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.
AD  - Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, 
      Israel.
LA  - eng
PT  - Journal Article
PL  - Israel
TA  - Isr Med Assoc J
JT  - The Israel Medical Association journal : IMAJ
JID - 100930740
RN  - 0 (Troponin)
SB  - IM
CIN - Isr Med Assoc J. 2019 Sep;21(9):624-625. PMID: 31542910
MH  - Acute Coronary Syndrome/*blood/*diagnostic imaging
MH  - Aged
MH  - Cohort Studies
MH  - Female
MH  - Heart/diagnostic imaging
MH  - Humans
MH  - Male
MH  - Myocardial Perfusion Imaging/*methods
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Troponin/*blood
EDAT- 2019/09/23 06:00
MHDA- 2019/10/08 06:00
CRDT- 2019/09/23 06:00
PHST- 2019/09/23 06:00 [entrez]
PHST- 2019/09/23 06:00 [pubmed]
PHST- 2019/10/08 06:00 [medline]
PST - ppublish
SO  - Isr Med Assoc J. 2019 Sep;21(9):603-606.