“If a patient has chest pain and goes directly to CT the negative predictive value is so high that more than half the patients can safely go straight home. I’m not a big fan of CT, but this is what the numbers show,” he said
Dr. Marwick acknowledged that testing a patient’s blood level of troponin using a high-sensitivity assay might soon supplant CT, but for the time being high-sensitivity troponin remain too non specific, he said. A retrospective, Swedish study reported at the 2014 annual meeting of the American College of Cardiology documented that a high-sensitivity troponin assay could rule out myocardial infarction among patients presenting with chest pain at an emergency department with a negative predictive accuracy of nearly 100%. But at that time one expert commented that proof of the clinical utility of a high-sensitivity troponin assay for emergency chest pain patients needed validation in a well-designed, prospective trial.
Dr. Petersen and Dr. Marwick had no disclosures.
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