Troponin Testing in the Emergency Department—When 2 Become 1

Abstract

Chest pain is among the main reasons for presentation at the emergency department (ED). The challenge for clinicians is not only to identify patients who are likely to have an acute coronary syndrome (ACS) but also to identify low-risk patients who may be safely discharged without a prolonged stay for further investigation. During the past 2 decades, evaluation of patients with chest pain has made a huge transition, especially with the introduction of cardiac troponin measurements and risk stratification tools. Risk scores, which are generally developed to aid the physician in making a careful and timely decision, have improved significantly over time. From the PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin), TIMI (Thrombolysis in Myocardial