OBJECTIVES: This study compared diagnostic accuracy of conventional troponin/traditional @entity453 ( @entity453 ) assessment and highly sensitive troponin (hsTn) I/advanced @entity453 assessment for @entity1187 ( @entity1187 ) during the index hospitalization. BACKGROUND: hsTnI and advanced assessment of @entity453 using coronary computed tomography angiography (CTA) are promising candidates to improve the accuracy of emergency department evaluation of @entity1 with suspected @entity1187 . METHODS: We performed an observational cohort study in @entity1 with suspected @entity1187 enrolled in the ROMICAT II (Rule Out @entity583 / @entity63 using Computer Assisted Tomography) trial and randomized to coronary CTA who also had hsTnI measurement at the time of the emergency department presentation. We assessed coronary CTA for traditional (no @entity453 , nonobstructive @entity453 ,  >= 50% @entity850 ) and advanced features of @entity453 (>= 50% @entity850 , high-risk plaque features: positive remodeling, low  <30-Hounsfield units plaque, napkin-ring sign, spotty @entity460 ). RESULTS: Of 160 @entity1 (mean age: 53    8 years, 40% @entity1 ) 10.6% were diagnosed with @entity1187 . The @entity1187 rate in @entity1 with hsTnI below the limit of detection (n  = 9, 5.6%), intermediate (n  = 139, 86.9%), and above the 99(th) percentile (n  = 12, 7.5%) was 0%, 8.6%, and 58.3%, respectively. Absence of  >= 50% @entity850 and high-risk plaque ruled out @entity1187 in @entity1 with intermediate hsTnI (n  = 87, 54.4%; @entity1187 rate 0%), whereas @entity1 with both  >= 50% @entity850 and high-risk plaque were at high risk (n  = 13, 8.1%; @entity1187 rate 69.2%) and @entity1 with either  >= 50% @entity850 or high-risk plaque were at intermediate risk for @entity1187 (n  = 39, 24.4%; @entity1187 rate 7.7%). hsTnI/advanced coronary CTA assessment significantly improved the diagnostic accuracy for @entity1187 as compared to conventional troponin/traditional coronary CTA (area under the curve 0.84, 95% confidence interval [CI] 0.80 to .88 vs. 0.74, 95%CI 0.70 to 0.78; p  < 0.001). CONCLUSIONS: hsTnI at the time of presentation followed by early advanced coronary CTA assessment improves the risk stratification and diagnostic accuracy for @entity1187 as compared to conventional troponin and traditional coronary CTA assessment. (Multicenter Study to Rule Out @entity583 / @entity63 by Cardiac Computed Tomography [ROMICAT-II]; NCT01084239).

hs-Troponin I Followed by CT Angiography Improves Acute Coronary Syndrome Risk Stratification Accuracy and Work-Up in Acute Chest Pain XXXX : Results From ROMICAT II Trial.

@entity1 :: ('9606', 'Species') :: ['women', 'patients'] @entity1187 :: ('MESH:D054058', 'Disease') :: ['ACS', 'acute coronary syndrome'] @entity583 :: ('MESH:D009203', 'Disease') :: ['Myocardial Infarction'] @entity63 :: ('MESH:D007511', 'Disease') :: ['Ischemia'] @entity460 :: ('MESH:D002118', 'Chemical') :: ['calcium'] @entity453 :: ('MESH:D003324', 'Disease') :: ['CAD', 'coronary artery disease'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis']
@entity1 :: (9606,Species) :: ['Patients']
