September 3, 2015
LONDON — A new algorithm incorporating a more sensitive cutoff for troponin I values to identify non-STEMI would result in lower mortality and allow more rapid treatment or discharge of patients with acute chest pain, according to results from the BACC trial presented at the European Society of Cardiology Congress.
Dirk Westermann, MD, PhD, and colleagues evaluated 1,045 patients with acute chest pain indicative of MI who presented at a hospital in Germany. Troponin I levels were assessed at admission and again 3 hours later, according to current guidelines, as well as at 1 hour after admission. Patients were diagnosed with non-STEMI using the standard approach (n = 184), with a troponin I value higher than the 99th percentile, or 27 ng/L for the assay used (STAT high sensitive Troponin I, Abbott Diagnostics), as the cutoff. Follow-up was conducted for 6 months among those with non-STEMI and 793 patients discharged without an acute MI diagnosis. Patients with STEMI were excluded from analysis.