REBEL EM - March 03, 2021 - By Benjamin M Gerretsen
Paper: Wassie et al. Single versus serial measurements of cardiac troponin in the evaluation of emergency department patients with suspected acute myocardial infarction. JAMA Network Open 2021. [Link is HERE]
“Clinical Question: Do emergency department patients discharged after a single negative troponin test have similar outcomes to patients receiving multiple tests?
Author Conclusion: “When compared to serial troponin testing, discharge after a single negative conventional troponin is routinely done among ED patients, and appears safe based on current physician decision-making with no difference in rates of 30-day cardiac mortality and AMI.”
Clinical Take Home Point: Discharging patients presenting to the ED with chest pain after a single negative conventional troponin and proper risk stratification with the HEART score can be considered to be as safe as serial troponin testing while being less time consuming, less costly and therefore more patient oriented.”