Home Bratislava Medical Journal 2022 Bratislava Medical Journal Vol.123, No.4, p.282–290, 2022

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Published Monthly, in English
Founded: 1919
ISSN 0006-9248
(E)ISSN 1336-0345

Impact factor 1.2

 

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Bratislava Medical Journal Vol.123, No.4, p.282–290, 2022

Title: Comparison of six decision aid rules for diagnosis of acute myocardial infarction in elderly patients presenting to the emergency department with acute chest pain
Author: Juraj HRECKO, Jiri DOKOUPIL, Radek PUDIL

Abstract: OBJECTIVE: This study aimed to evaluate the accuracy and effectiveness of different strategies for the diagnosis of acute myocardial infarction (AMI) in the elderly in real-life clinical practice.
METHODS: Patients older than 70 years presenting to the emergency department with chest pain were included. The performance of six decision aid rules (T-MACS, HEART, EDACS, TIMI, GRACE, and ADAPT) and solo troponin T strategy for diagnosing AMI was evaluated by calculating sensitivity, specificity, odds ratios, negative and positive predictive values.
RESULTS: A total of 250 patients, with a mean age of 78.5 years, were enrolled. Forty-eight patients (19.2 %) had an acute myocardial infarction in a 30 day follow-up period. The sensitivity for ruling-out AMI was 100 % for T-MACS, HEART, and ADAPT; 97.9 % for EDACS, 93.8 % for TIMI, and 81.3 % for GRACE and solo TnT strategy. For ruling-in AMI, the specificity was 97.5 % for T-MACS, 95 % for TIMI, 83.2 % for HEART, 81.7 % for GRACE, and 46 % for ADAPT.
CONCLUSION: T-MACS decision aid had the best performance for rule-out and rule-in diagnostics of AMI. Risk stratification of patients with suspected acute coronary syndrome based on decision aid rules can be used in real-life practice, even in the population of the elderly (Tab. 6, Fig. 1, Ref. 17).

Keywords: decision aid rules, acute myocardial infarction, elderly
Published online: 16-Mar-2022
Year: 2022, Volume: 123, Issue: 4 Page From: 282, Page To: 290
doi:10.4149//BLL_2022_045


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