The Single High-Sensitivity Serum Cardiac Troponin T Level: A Significant Advance for Chest Pain Pathways?
Authors: William G. Kussmaul III
Journal: Annals of Internal Medicine (2017)

Editorials16 May 2017The Single High-Sensitivity Serum Cardiac Troponin T Level: A Significant Advance for Chest Pain Pathways?William G. Kussmaul III, MDWilliam G. Kussmaul III, MDFrom Hahnemann University Hospital, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-0919 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Several years ago, the urban teaching hospital where I work instituted a “Chest Pain Pathway” in the emergency department (ED). Emergency physicians were taking more authority over admission decisions in general, which was understandable—many a patient had languished in a bed or on a stretcher while consultants made their way to the ED, examined the patient and studied the data, and pondered whether to admit. It seemed more efficient to let the ED physicians make the decision. Inpatient resident and attending physicians could decide to which unit the patient would be admitted.At its inception, the Chest Pain Pathway concept ...References1. Pickering JW, Than MP, Cullen L, Aldous S, terAvest E, et al. Rapid rule-out of myocardial infarction with a high-sensitivity cardiac troponin T measurement below the limit of detection. A collaborative meta-analysis. Ann Intern Med. 2017;166:715-24. doi:10.7326/M16-0562 LinkGoogle Scholar2. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al; Joint ESC/ACCF/AHA/WHF Task Force for Universal Definition of Myocardial Infarction. Third universal definition of myocardial infarction. J Am Coll Cardiol. 2012;60:1581-98. [PMID: 22958960] doi:10.1016/j.jacc.2012.08.001 CrossrefMedlineGoogle Scholar3. Bhatt DL, Taqueti VR. Out with the old rule-out: raising the bar for acute chest pain evaluation with randomized trials of cardiac imaging [Editorial]. JACC Cardiovasc Imaging. 2017;10:350-3. [PMID: 28279383] doi:10.1016/j.jcmg.2016.12.008 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Hahnemann University Hospital, Philadelphia, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0919.Corresponding Author: William G. Kussmaul III, MD, Hahnemann University Hospital, 230 North Broad Street, Room 1536, South Tower, Philadelphia, PA 19102.This article was published at Annals.org on 18 April 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRapid Rule-out of Acute Myocardial Infarction With a Single High-Sensitivity Cardiac Troponin T Measurement Below the Limit of Detection John W. Pickering , Martin P. Than , Louise Cullen , Sally Aldous , Ewoud ter Avest , Richard Body , Edward W. Carlton , Paul Collinson , Anne Marie Dupuy , Ulf Ekelund , Kai M. Eggers , Christopher M. Florkowski , Yonathan Freund , Peter George , Steve Goodacre , Jaimi H. Greenslade , Allan S. Jaffe , Sarah J. Lord , Arash Mokhtari , Christian Mueller , Andrew Munro , Sebbane Mustapha , William Parsonage , W. Frank Peacock , Christopher Pemberton , A. Mark Richards , Juan Sanchis , Lukas P. Staub , Richard Troughton , Raphael Twerenbold , Karin Wildi , and Joanna Young Metrics 16 May 2017Volume 166, Issue 10Page: 751KeywordsDisclosureEmergency departmentHematologic testsInpatientsIschemiaMyocardial infarctionSpecificityTriageTroponinTroponin T ePublished: 18 April 2017 Issue Published: 16 May 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...