T-MACS score vs HEART score identification of major adverse cardiac events in the emergency department

Akman, Gürkan; Hökenek, Nihat Müjdat; Yusufoglu, Kaan; Akman, Damla; Haği, Orhan; Bayramoğlu, Burcu; Yavuz, Burcu Genç; Çolak, Şahin

doi:10.1016/j.ajem.2022.11.015

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…Rapid diagnosis of acute myocardial infarction (AMI) in the ED is important to improve patient outcomes and efficiently manage patient flow. Decision aids that support rapid ‘rule-in’ or ‘rule-out’ diagnosis for AMI facilitate quicker access to care for patients that require it and early discharge in patients who do not 4…”

Section: T-macs Score Versus Heart Score Identification Of Major Adve...mentioning

confidence: 99%

Journal update monthly top five

et al. 2023

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Word count including subheadings & bottom line (excluding references): 1485This month's update is by the EMJ journal update monthly top five core team. We used a multimodal search strategy, drawing on free open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlight the main findings, key limitations and clinical bottom line for each paper.The papers are ranked as: Worth a peek-interesting, but not yet ready for prime time. Head turner-new concepts. Game changer-this paper could/should change practice.

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Section: T-macs Score Versus Heart Score Identification Of Major Adve...mentioning

confidence: 99%

Journal update monthly top five

et al. 2023

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Performance of Manchester Acute Coronary Syndromes decision rules in acute coronary syndrome: a systematic review and meta-analysis

Roshdi Dizaji,

Ahmadzadeh,

Zarei

et al. 2024

European Journal of Emergency Medicine

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Background and importance Multiple decision-aiding models are available to help physicians identify acute coronary syndrome (ACS) and accelerate the decision-making process in emergency departments (EDs). Objective This study evaluates the diagnostic performance of the Manchester Acute Coronary Syndrome (MACS) rule and its derivations, enhancing the evidence for their clinical use. Design Systematic review and meta-analysis. Settings and participants Medline, Embase, Scopus, and Web of Science were searched from inception until October 2023 for studies including adult ED patients with suspected cardiac chest pain and inconclusive findings requiring ACS risk-stratification. Outcome measures and analysis The predictive value of MACS, Troponin-only MACS (T-MACS), or History and Electrocardiogram-only MACS (HE-MACS) decision aids for diagnosing acute myocardial infarction (AMI) and 30-day major adverse cardiac outcomes (MACEs) among patients admitted to ED with chest pain suspected of ACS. Overall sensitivity and specificity were synthesized using the ‘Diagma’ package in STATA statistical software. Applicability and risk of bias assessment were performed using the QUADAS-2 tool. Main results For AMI detection, MACS has a sensitivity of 99% [confidence interval (CI): 97–100], specificity of 19% (CI: 10–32), and AUC of 0.816 (CI: 0.720–0.885). T-MACS shows a sensitivity of 98% (CI: 98–99), specificity of 35% (CI: 29–42), and AUC of 0.859 (CI: 0.824–0.887). HE-MACS exhibits a sensitivity of 99% (CI: 98–100), specificity of 9% (CI: 3–21), and AUC of 0.787 (CI: 0.647–0.882). For MACE detection, MACS demonstrates a sensitivity of 98% (CI: 94–100), specificity of 22% (CI: 10–42), and AUC of 0.804 (CI: 0.659–0.897). T-MACS displays a sensitivity of 96% (CI: 94–98), specificity of 36% (CI: 30–43), and AUC of 0.792 (CI: 0.748–0.830). HE-MACS maintains a sensitivity of 99% (CI: 97–99), specificity of 10% (CI 6–16), and AUC of 0.713 (CI: 0.625–0.787). Conclusion Of all the MACS models, T-MACS displayed the highest overall accuracy due to its high sensitivity and significantly superior specificity. T-MACS exhibits very good diagnostic performance in predicting both AMI and MACE. This makes it a highly promising tool for managing patients with acute chest pain.

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T-MACS score vs HEART score identification of major adverse cardiac events in the emergency department

Cited by 2 publications

References 21 publications

Journal update monthly top five

Journal update monthly top five

Performance of Manchester Acute Coronary Syndromes decision rules in acute coronary syndrome: a systematic review and meta-analysis

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