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Accuracy of prehospital HEART score risk classification using point of care vs high sensitive troponin in suspected NSTE-ACS

The American Journal of Emergency Medicine Oct 12, 2019

van Dongen DN, Fokkert MJ, Tolsma RT, et al. - Prehospital HEART-score risk classification using point of care troponin vs high sensitive troponin was compared. Prehospital derived blood samples from 689 consecutive patients [Mean age:64 (SD±14)] with suspected NSTE-ACS were assessed for point of care troponin and laboratory high-sensitive troponin. Researchers determined the HEART score with both point of care troponin (HEART-POC) and high sensitive troponin (HEART-hsTnT) for every patient. HEART-hsTnT indicated 163 (24%) patients at low-risk and HEART-POC indicated 170 (25%) patients at low-risk. MACE occurred in 17% of the cases. Although one-fifth of patients were dissimilar regarding high sensitive vs POC troponin scoring, this resulted in different patient risk classification in only 2 percent of patients. This supports POC troponin measurement for prehospital risk stratification of suspected NSTE-ACS.
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