The EDACS-ADP identified approximately half of the patients presenting to the ED with possible cardiac chest pain as having low risk of short-term major adverse cardiac events, with high sensitivity. This is a significant improvement on similar, previously reported protocols. The EDACS-ADP is reproducible and has the potential to make considerable cost reductions to health systems.

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T he use of a single high-sensitivity cardiac troponin (hscTn) test concentration on presentation to the emergency department has been proposed for triage and early decision-making in patients with suspected acute coronary syndrome.1-3 However, a single low concentration result for hscTn for identifying patients at low risk in the emergency department may misclassify patients, because an analytical variation of ± 3 ng/L for the hs-cTn assays at the low analytical range is RESEARCH Clinical chemistry score versus high-sensitivity cardiac troponin I and T tests alone to identify patients at low or high risk for myocardial infarction or death at presentation to the emergency department ABSTRACT BACKGROUND: Testing for high-sensitivity cardiac troponin (hs-cTn) may assist triage and clinical decision-making in patients presenting to the emergency department with symptoms of acute coronary syndrome; however, this could result in the misclassification of risk because of analytical variation or laboratory error. We sought to evaluate a new laboratorybased risk-stratification tool that incorporates tests for hs-cTn, glucose level and estimated glomerular filtration rate to identify patients at risk of myocardial infarction or death when presenting to the emergency department.