{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:45Z","timestamp":1791849645029,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,3,11]],"date-time":"2017-03-11T00:00:00Z","timestamp":1489190400000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001078","name":"Queensland Emergency Medicine Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001078","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2017,3]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n \n The electrocardiograph (\n ECG<\/jats:styled-content>\n ) is an essential tool in initial management and risk stratification of patients with suspected acute coronary syndrome (\n ACS<\/jats:styled-content>\n ). A six\u2010point reporting criterion has been proposed to facilitate standardized clinical assessment of patients presenting to the emergency department (\n ED<\/jats:styled-content>\n ) with suspected\n ACS<\/jats:styled-content>\n . We set out to evaluate the efficacy of these criteria in identifying patients with major adverse cardiac events (\n MACE<\/jats:styled-content>\n ), Type 1 myocardial infarction (T1\n MI<\/jats:styled-content>\n ), Type 2 myocardial infarction (T2\n MI<\/jats:styled-content>\n ), and 1\u2010year mortality in a cohort of emergency patients with chest pain.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This was an analysis of data from 2,349 patients who presented to the\n ED<\/jats:styled-content>\n with chest pain between 2008 and 2013. Data were collected as part of two prospective trials.\n ECG<\/jats:styled-content>\n s were recorded at presentation and categorized according to the six\u2010point criteria by local cardiologists blinded to all clinical information. The primary outcome was 30\u2010day\n MACE<\/jats:styled-content>\n , including T1\n MI<\/jats:styled-content>\n , T2\n MI<\/jats:styled-content>\n , unstable angina pectoris, revascularization, and 30\u2010day mortality. The outcome was adjudicated by cardiologists on the basis of all clinical information and test results. Likelihood ratios and odds ratios for 30\u2010day\n MACE<\/jats:styled-content>\n were reported for each\n ECG<\/jats:styled-content>\n category.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Major adverse cardiac events were diagnosed in 264 (11.3%) patients. Increasing ischemic abnormalities in\n ECG<\/jats:styled-content>\n s, as categorized by the standardized reporting criteria, were associated with increasing rates of\n MACE<\/jats:styled-content>\n . Within 30 days, T1\n MI<\/jats:styled-content>\n occurred in 148 (6.3%) patients and T2\n MI<\/jats:styled-content>\n occurred in 59 (2.5%) patients. Risk for T1\n MI<\/jats:styled-content>\n increased with higher classification of\n ECG<\/jats:styled-content>\n abnormalities. T2\n MI<\/jats:styled-content>\n rates were highest in patients with\n ECG<\/jats:styled-content>\n s of nonspecific changes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The rates of\n MACE<\/jats:styled-content>\n , T1\n MI<\/jats:styled-content>\n , and 1\u2010year death can be stratified according to standardized\n ECG<\/jats:styled-content>\n criteria in patients presenting to the\n ED<\/jats:styled-content>\n with chest pain. The\n ECG<\/jats:styled-content>\n findings in patients with T2\n MI<\/jats:styled-content>\n are variable, and the\n ECG<\/jats:styled-content>\n is less helpful in defining risk in this group.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/acem.13123","type":"journal-article","created":{"date-parts":[[2017,3,11]],"date-time":"2017-03-11T13:26:59Z","timestamp":1489238819000},"page":"344-352","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Association of Electrocardiographic Abnormalities and Acute Coronary Syndrome in Emergency Patients With Chest Pain"],"prefix":"10.1111","volume":"24","author":[{"given":"Thomas","family":"Knowlman","sequence":"first","affiliation":[{"name":"School of Medicine University of Queensland Brisbane Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaimi H.","family":"Greenslade","sequence":"additional","affiliation":[{"name":"School of Medicine University of Queensland Brisbane Queensland"},{"name":"School of Public Health Queensland University of Technology Brisbane Queensland"},{"name":"Department of Emergency Medicine Royal Brisbane and Women's Hospital Brisbane Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Parsonage","sequence":"additional","affiliation":[{"name":"School of Medicine University of Queensland Brisbane Queensland"},{"name":"Department of Cardiology Royal Brisbane and Women's Hospital Brisbane Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"Hawkins","sequence":"additional","affiliation":[{"name":"School of Public Health Queensland University of Technology Brisbane Queensland"},{"name":"Department of Emergency Medicine Royal Brisbane and Women's Hospital Brisbane Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorcan","family":"Ruane","sequence":"additional","affiliation":[{"name":"School of Medicine 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