{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:31:15Z","timestamp":1784035875649,"version":"3.55.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The TRAPID-AMI trial study (High-Sensitivity Troponin-T Assay for Rapid Rule-Out of Acute Myocardial Infarction) evaluated high-sensitivity cardiac troponin-T (hs-cTnT) in a 1-hour acute myocardial infarction (AMI) exclusion algorithm. Our study objective was to evaluate the prognostic utility of a modified HEART score (m-HS) within this trial.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Twelve centers evaluated 1282 patients in the emergency department for possible AMI from 2011 to 2013. Measurements of hs-cTnT (99th percentile, 14 ng\/L) were performed at 0, 1, 2, and 4 to 14 hours. Evaluation for major adverse cardiac events (MACEs) occurred at 30 days (death or AMI). Low-risk patients had an m-HS\u22643 and had either hs-cTnT&lt;14 ng\/L over serial testing or had AMI excluded by the 1-hour protocol. By the 1-hour protocol, 777 (60%) patients had an AMI excluded. Of those 777 patients, 515 (66.3%) patients had an m-HS\u22643, with 1 (0.2%) patient having a MACE, and 262 (33.7%) patients had an m-HS\u22654, with 6 (2.3%) patients having MACEs (\n              <jats:italic>P<\/jats:italic>\n              =0.007). Over 4 to 14 hours, 661 patients had a hs-cTnT&lt;14 ng\/L. Of those 661 patients, 413 (62.5%) patients had an m-HS\u22643, with 1 (0.2%) patient having a MACE, and 248 (37.5%) patients had an m-HS\u22654, with 5 (2.0%) patients having MACEs (\n              <jats:italic>P<\/jats:italic>\n              =0.03).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Serial testing of hs-cTnT over 1 hour along with application of an m-HS identified a low-risk population that might be able to be directly discharged from the emergency department.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.116.003101","type":"journal-article","created":{"date-parts":[[2017,2,7]],"date-time":"2017-02-07T02:10:48Z","timestamp":1486433448000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":76,"title":["Prognostic Utility of a Modified HEART Score in Chest Pain Patients in the Emergency Department"],"prefix":"10.1161","volume":"10","author":[{"given":"James","family":"McCord","sequence":"first","affiliation":[{"name":"From the Henry Ford Heart &amp; Vascular Institute (J.M., R.C., T.F.), Department of Emergency Medicine (R.N.), and Department of Public Health Sciences (G.J.), Henry Ford Health System, Detroit, MI; Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (B.L.); Department of Internal Medicine III, Cardiology, Angiology &amp; Pulmonology, University Hospital Heidelberg, Germany (E.G.); Department of Internal Medicine, Henry Ford Hospital Health System,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Cabrera","sequence":"additional","affiliation":[{"name":"From the Henry Ford Heart &amp; Vascular Institute (J.M., R.C., T.F.), Department of Emergency Medicine (R.N.), and Department of Public Health Sciences (G.J.), Henry Ford Health System, Detroit, MI; Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (B.L.); Department of Internal Medicine III, Cardiology, Angiology &amp; Pulmonology, University Hospital Heidelberg, Germany (E.G.); Department of Internal Medicine, Henry Ford Hospital Health System,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertil","family":"Lindahl","sequence":"additional","affiliation":[{"name":"From the Henry Ford Heart &amp; Vascular Institute (J.M., R.C., T.F.), Department of Emergency Medicine (R.N.), and Department of Public Health Sciences (G.J.), Henry Ford Health System, Detroit, MI; Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (B.L.); Department of Internal Medicine III, Cardiology, Angiology &amp; Pulmonology, University Hospital Heidelberg, Germany (E.G.); Department of Internal Medicine, Henry Ford Hospital Health 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Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (B.L.); Department of Internal Medicine III, Cardiology, Angiology &amp; Pulmonology, University Hospital Heidelberg, Germany (E.G.); Department of Internal Medicine, Henry Ford Hospital Health System,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Nowak","sequence":"additional","affiliation":[{"name":"From the Henry Ford Heart &amp; Vascular Institute (J.M., R.C., T.F.), Department of Emergency Medicine (R.N.), and Department of Public Health Sciences (G.J.), Henry Ford Health System, Detroit, MI; Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (B.L.); Department of Internal Medicine III, Cardiology, Angiology &amp; Pulmonology, University Hospital Heidelberg, Germany (E.G.); Department of Internal Medicine, Henry Ford Hospital Health 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Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (B.L.); Department of Internal Medicine III, Cardiology, Angiology &amp; Pulmonology, University Hospital Heidelberg, Germany (E.G.); Department of Internal Medicine, Henry Ford Hospital Health System,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Christ","sequence":"additional","affiliation":[{"name":"From the Henry Ford Heart &amp; Vascular Institute (J.M., R.C., T.F.), Department of Emergency Medicine (R.N.), and Department of Public Health Sciences (G.J.), Henry Ford Health System, Detroit, MI; Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (B.L.); Department of Internal Medicine III, Cardiology, Angiology &amp; Pulmonology, University Hospital Heidelberg, Germany (E.G.); Department of Internal Medicine, Henry Ford Hospital Health 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