Evidence map›Paper›PMID 40607172›Full record

ArticleAmerican journal of medicine open2025

Implementation of High-Sensitivity Troponin for Early Rule-Out of Acute Myocardial Infarction in Emergency Department.

Alexandra M Cruz Pabón, Eric Pyles, Daniel Peach, Sarfraz Ahmad, Paul Blake O'Brien, Michael Kuhlman, Sarah Steiner, Lara Crown, Elizabeth Purinton, James Priano

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of medicine open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Alexandra M Cruz PabónAdventhHealth Orlando, Pharmacy Department, Orlando, FL, USA.
Eric PylesAdventhHealth Orlando, Pharmacy Department, Orlando, FL, USA.
Daniel PeachAdventHealth Corporate, Clinical Innovation Department, Orlando, FL, USA.
Sarfraz AhmadAdventHealth Cancer Institute, Orlando, FL, USA.
Paul Blake O'BrienAdventHealth Orlando, Emergency Medicine, Orlando, FL, USA.
Michael KuhlmanAdventHealth Corporate, Clinical Innovation Department, Orlando, FL, USA.
Sarah SteinerAdventHealth Corporate, Clinical Innovation Department, Orlando, FL, USA.
Lara CrownInstitute Value & Clinical Outcomes, Orlando, FL, USA.
Elizabeth PurintonInstitute Value & Clinical Outcomes, Orlando, FL, USA.
James PrianoAdventhHealth Orlando, Pharmacy Department, Orlando, FL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background/Purpose: Chest pain is a common reason for ED visits. Implementing a HEART score-based algorithm previously increased early discharges by 99%. This study aims to determine if the transition from cTnT to hs-cTnT assays affected patient disposition rates. Methods: This retrospective observational study was conducted in a multi-site hospital system. Adults presenting to the ED with chest pain and a low HEART score (≤3) between November 9, 2020, and November 10, 2022, were included. The primary outcome was the change in patient disposition. Secondary outcomes included length-of-stay (LOS), rates of provocative testing, ED returns, and major adverse cardiovascular events (MACE). Results: We evaluated 32,968 patients (17,173 in the cTnT group and 15,795 in the hs-cTnT group). Both groups had a similar median age, but the hs-cTnT group had a higher proportion of patients with baseline troponin elevations. The ED discharge rate was higher in the hs-cTnT group (87.5%) compared to the cTnT group (85.3%; Conclusions: Integration of hs-cTnT into our chest pain clinical pathway resulted in increased ED discharges, reduced LOS, and fewer additional tests without a change in MACE. This translates to a savings of almost 7,000 ED hours annually without compromising safety.

Indexed as

Acute myocardial InfarctionChest painClinical pathwaysEmergency departmentLength-of-stayPatient disposition rateQuality improvementTroponin

Identifiers

PMID40607172
PMCPMC12214248

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.