High-sensitivity troponin T use in non-chest pain presentations in the emergency department

Emerg Med Australas. 2020 Oct;32(5):864-866. doi: 10.1111/1742-6723.13590. Epub 2020 Aug 2.

Abstract

Objective: To explore troponin testing yield in patients who present to the ED without chest pain.

Methods: A retrospective medical record audit of all patients who presented to ED in November 2018 and had troponin measured.

Results: A total of 1124 troponin assays were performed in 763 patients, 48.7% had no documented chest pain; 8.8% of these met high-risk criteria and 1.1% were diagnosed with acute coronary syndrome.

Conclusions: Despite ED troponin testing in the absence of chest pain being common practice, it rarely assisted in a meaningful diagnosis. Consequences of testing may include delays to patient discharge and additional downstream testing.

Keywords: acute coronary syndrome; troponin; unnecessary testing.

MeSH terms

  • Acute Coronary Syndrome* / diagnosis
  • Biomarkers
  • Chest Pain / diagnosis
  • Chest Pain / etiology
  • Emergency Service, Hospital
  • Humans
  • Retrospective Studies
  • Troponin
  • Troponin T / therapeutic use*

Substances

  • Biomarkers
  • Troponin
  • Troponin T