Proposal for the use in emergency departments of cardiac troponins measured with the latest generation methods in patients with suspected acute coronary syndrome without persistent ST-segment elevation
1 Emergency Department, Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy2 Emergency Department, Sant'Orsola-Malpighi Hospital, Bologna, Italy3 Fondazione G. Monasterio CNR-Regione Toscana and Scuola Superiore Sant′Anna, Pisa, Italy4 Division of Cardiology, Morgagni-Pierantoni Hospital, Forlì, Italy5 Department of Laboratory Medicine, University-Hospital, Padua, Italy6 Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy7 Emergency Department, Academic Hospital of Parma, Parma, Italy8 Emergency Department, Ospedale Civile Santa Maria della Scaletta, Imola, Italy9 Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy10 Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy11 (coordinator)
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The purpose of this document is to develop recommendations on the use of the latest generation of cardiac troponins in emergency room settings for the diagnosis of myocardial infarction in patients with suspected acute coronary syndrome (ACS) without persistent ST-segment elevation (NSTE-ACS). The main points which have been addressed reaching a consensus are represented by:Suitability and appropriateness of the terminology.Appropriateness of the request.Confirmation of the diagnosis of myocardial infarction (rule-in).Exclusion of the diagnosis of myocardial infarction (rule-out).Work method: Each point has been analyzed by taking into account the evidence presented in medical publications. Recommendations were developed using the criteria adopted by the European Society of Cardiology and the American Heart Association/American College of Cardiology (www.escardio.org/guidelines). Each point of the recommendation was submitted for validation to an external audit by a Group of Experts (named above).