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Troponin-Only Manchester Acute Coronary Syndrome Decision Aid

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Troponin-Only Manchester Acute Coronary Syndrome Decision Aid, T-Macs

  • See Also
  1. HEART Score
  2. Emergency Department Assessment of Chest Pain Score (EDACS)
  • Criteria
  1. EKG Ischemia (E)
    1. Score 0: No
    2. Score 1: Yes
  2. Worsening or Crescendo Angina (A)
    1. Score 0: No
    2. Score 1: Yes
  3. Pain radiation to the right arm or Shoulder (R)
    1. Score 0: No
    2. Score 1: Yes
  4. Pain with Vomiting (V)
    1. Score 0: No
    2. Score 1: Yes
  5. Sweating observed (S)
    1. Score 0: No
    2. Score 1: Yes
  6. Hypotension (H)
    1. Score 0: No
    2. Score 1: Yes
  7. Troponin (hs-cTnT) level on arrival (T)
    1. Use hs-cTnT level
  • Interpretation
  1. Factors (sum these)
    1. E * 1.713
    2. A * 0.847
    3. R * 0.607
    4. V * 1.417
    5. S * 2.085
    6. H * 1.208
    7. T * 0.089
  2. Calculation
    1. Probability = 1/1+e^-FactorSum
    2. Result is the predicted probability for short-term adverse cardiac outcome (<1% is considered low risk)
  • Efficacy
  1. Test Sensitivity 98-99%
  • References
  1. Body (2017) Emerg Med J 34(6): 349-56 [PubMed]