WASHINGTON – The lack of detectable high-sensitivity cardiac troponin T in patients presenting with chest pain may be a marker of minimal risk of myocardial infarction within 30 days, according to Dr. Nadia Bandstein of the department of medicine at the Karolinska Institute, Solna, Sweden.
She and her colleagues looked at data from all emergency department visits for chest pain during 2010-2012 in Sweden. They found that the negative predictive value of myocardial infarction at 30 days for patients reporting with an hs-cTnT level of less than 5 ng/L, in addition to an ECG showing no blood flow-related damage, was 99.8%. That negative predictive value for death, meaning the patients are not at risk, was 100%.
Discussant Dr. Allan Jaffe of the Mayo Clinic in Rochester, Minn., said in an interview that although these findings are promising, the documentation in this study is not sufficient to use in clinical practice to let patients with these characteristics leave the emergency department.
*Update (3/31/14): This video has been updated.