Learning Objectives Current Practices in Ruling Out AMI.

Slides:

Advertisements

Similar presentations

Tobias Reichlin, W. Hochholzer, C. Stelzig, K. Laule, M. Potocki, K

Advertisements

for the TRAPID-AMI Investigators

Copeptin and high sensitive Troponins Discussion of NEJM publications on sensitive Troponins BRAHMS GmbH, August 2010.

Sex-Specific Chest Pain Characteristics in AMI Jay Mansfield, Pgy-3 July 22, 2014 LSU Journal Club Gimenez, M, et. Al. Jama Int Med. 2014;174(2):

Journal Club Optimizing Early Rule-Out Strategies for Acute Myocardial Infarction: Utility of 1-Hour Copeptin P. Hillinger, R. Twerenbold, C. Jaeger, K.

Implementation of a Sensitive Troponin I Assay and Risk of Recurrent Myocardial Infarction and Death in Patients With Suspected Acute Coronary Syndrome.

LINC Trial LUCAS in cardiac arrest trial. What is LINC? A multicenter, randomized, controlled trial designed to evaluate the efficacy and safety of: LUCAS.

Date of download: 6/24/2016 Copyright © The American College of Cardiology. All rights reserved. From: Implications of Introducing High-Sensitivity Cardiac.

Involving Patients with Low Risk Chest Pain in Discharge Decisions: A Multicenter Trial Erik P. Hess MD MSc.

Introduction Data Statistical Methods Table 1: Prevalence of Prior Hip Fracture and Incidence of New Hip Fractures and Fractures of Any Type.

Date of download: 7/5/2016 Copyright © 2016 American Medical Association. All rights reserved. From: One-Hour Rule-out and Rule-in of Acute Myocardial.

Incidence of Undetectable, Measurable, and Increased Cardiac Troponin I Concentrations Above the 99th Percentile Using a High-Sensitivity Versus a Contemporary.

. Troponin limit of detection plus cardiac risk stratification scores for the exclusion of myocardial infarction and 30-day adverse cardiac events in ED.

Cocaine-Related Chest Pain: The Year After

One-hour rule-in and rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I Cedric Jaeger, MD, Karin Wildi, MD, Raphael Twerenbold,

Trends in Coronary Procedures per 1000 Medicare Beneficiaries

ICD-10 and Clinical Documentation

Update on the Diagnosis and Management of CTEPH in Latin America

Part III Lessons Learned: A Master Class in High-Sensitivity Troponin A Global Perspective.

Cardiac Troponin.

Acute Heart Failure.

Exploring the Spectrum of Excessive Daytime Sleepiness

NOACs, AF, and PCI: What Do the Latest Data Suggest?

Volume 2: End-Stage Renal Disease Chapter 4: Hospitalization

Introduction ESC Annual Meeting in Review: NOACs and NVAF: Real-World Data, Guidelines, and More.

Diagnostic Algorithms for ACS and High-Sensitivity Troponin

Cardiac Biomarkers.

Identifying Patients Suitable for Discharge After a Single-Presentation High-Sensitivity Troponin Result: A Comparison of Five Established Risk Scores.

Transition of Care in Epilepsy Among Patients Entering Long-Term Care

Part II: It Takes a Team— Incorporating High-Sensitivity Troponin Into Clinical Care.

The Mood Disorder Spectrum

Recurrent Angina: New Tools for an Old Problem

ACIP Recommended Vaccines for Adults – By Age

Screening and Diagnosing Postpartum Depression

Revealing Characteristics of Patients at High Risk for Developing Atrial Fibrillation.

Statins and New-Onset Diabetes REAL Updates and Clinical Implications

Improving Narcolepsy Diagnosis

Section A: Introduction

Are We Closer to Personalized Medicine in MS?

A Frontline Clinician's Guide to Managing Opioid-Induced Constipation

Part I: A Sensible Approach to Sensitive Troponin

Nat. Rev. Cardiol. doi: /nrcardio

Introduction. A Reality Check on BP Goals and Optimizing Patient Adherence to Treatment.

Selected Highlights of the Latest Advances in PAH

Advancing Acute Coronary Syndrome Assessment:

Issues in the Management of Hemophilia: A Best Practice Series

Tackling Atopic Dermatitis

Diagnosing Nontuberculous Mycobacterial Disease

EXAMINE Study: Cardiovascular Outcomes Study of Alogliptin in Subjects With Type 2 Diabetes and Acute Coronary Syndrome.

Oral Anticoagulation in AF

Remote Patient Management:

Pseudobulbar Affect or Psychiatric Condition?

Updated Guideline Recommendations for the Definitive Diagnosis of Unexplained Syncope.

Case Study 56-year-old Presents With 1 Year of Worsening Dyspnea

When Is Intrathecal Drug Delivery Appropriate?

What is LINC? A multicenter, randomized, controlled trial

Diabetes Pandemic. The Economics of Managing Patients With Diabetes and Coronary Artery Disease: A Payer Perspective.

Managing Age-Related Clinical Issues in Hemophilia

Undetectable High Sensitivity Cardiac Troponin T Level in the Emergency Department and Risk of Myocardial Infarction Nadia Bandstein, MD; Rickard Ljung,

Undetectable High Sensitivity Cardiac Troponin T Level in the Emergency Department and Risk of Myocardial Infarction Nadia Bandstein, MD; Rickard Ljung,

Elevated Admission Plasma Glucose Following ACS

DECLARE-TIMI 58.

Clinical Challenges and Updates in Managing Seizure Clusters

Assessing the Burden of Hyperkalemia

High-Sensitivity Troponin in Clinical Practice

When Is Intrathecal Drug Delivery Appropriate?

Assessing the Burden of Hyperkalemia

Update on better disease diagnosis

Evaluating the Science of Cardiogenic Shock

Performance of the Manchester Acute Coronary Syndromes decision rule with high-sensitivity cardiac troponin T (hs-cTnT) as the reference standard for the.

Presentation transcript:

Learning Objectives

Current Practices in Ruling Out AMI

6 Million Chest Pain Visits Evaluated Annually in the US

Can We Do Better?

3 Clinical Evaluation Tools

APACE hs-cTnT 1-Hour Algorithm

Patient Inclusion/Exclusion Criteria

ED Prevalence of Acute MI

TRAPID-AMI Results Presented at ESC 2014

Clinical Implications

Limitations

Baseline Patient Characteristics

One Cut-off Does Not Fit All

Age- and Sex-Dependent Upper Reference Limits for hs-cTnT

Could Older Adults Be at Greater Risk of A “False Positive” Diagnosis of AMI?

Algorithm is Based on 2 Main Concepts

Key Clinical Points

Recap 1-Hour Algorithm With Hs-cTnT

Differential Between MI Types 1 and 2 According to Condition of the Coronary Arteries

Take-Home Points and Summary

Abbreviations

Abbreviations (cont)

References

References (cont)