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Troponin Cut-Off Could Help Reduce Admissions, Costs

Could rule out MI for two-thirds of patients evaluated in emergency department

THURSDAY, Oct. 8, 2015 (HealthDay News) -- A cardiac troponin concentration of <5 ng/L identifies patients at very low risk of myocardial infarction (MI) either during admission or within the following 30 days, researchers report online Oct. 7 in The Lancet.

Anoop Shah, M.D., from the University of Edinburgh in the United Kingdom, and colleagues measured high-sensitivity cardiac troponin I assays in 6,304 patients admitted to the hospital with chest pain, and assessed their risk for MI and cardiac death within 30 days.

The investigators found that 61 percent of the patients with a troponin level below 5 ng/L were at very low risk of MI and could have been discharged early, regardless of age, gender, and risk factors for cardiovascular disease. One year out, these patients had a three times lower risk of MI and cardiac death than those with higher troponin levels, the researchers said.

"We have identified a cardiac troponin concentration (<5 ng/L) below which patients are at very low risk of heart attack either during the admission or in the ensuing 30 days," Shah said in a journal news release. "These patients are therefore potentially suitable for immediate and safe discharge from the emergency department. These findings could dramatically reduce unnecessary hospital admissions and provide substantial cost savings for health care providers."

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