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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    History and Electrocardiogram-only Manchester Acute Coronary Syndromes (HE-MACS)

    Stratifies ACS risk with history and EKG only (not yet externally validated).

    INSTRUCTIONS

    Use in patients ≥18 years old presenting with suspected cardiac chest pain (symptoms within the last 24 hours).

    When to Use
    Pearls/Pitfalls
    Why Use

    Patients ≥18 years old presenting with suspected cardiac chest pain (symptoms within the last 24 hours).

    • 30-day major adverse cardiac event (MACE) was defined as acute MI, all-cause death, or coronary revascularization.

    • Not yet prospectively validated (externally validated in a single cohort retrospectively; see Evidence for details).

    • Validated in emergency settings and not yet validated in paramedic, primary care, or triage-specific settings.

    Point to keep in mind:

    • Note that the authors chose the cutoff for ACS probability in the “very low risk” group (<4%) as determined by receiver operator curve (ROC) analysis to achieve 100% sensitivity (i.e., to miss no cases of ACS or 30-day MACE), not necessarily as a reasonable clinical risk threshold for rule-out.

    • May be a useful adjunct to clinical judgment, especially in resource-limited settings where biomarkers are not available.

    • Accurate risk stratification of patients prior to biomarker information may enhance triage and help guide disposition.

    years
    Female
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    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights
    Abdulrhman Alghamdi

    About the Creator

    Abdulrhman Alghamdi, BS, MS, is a researcher and PhD candidate specializing in critical care and cardiovascular sciences at the University of Manchester in the UK. His primary research is focused on diagnosis of early acute coronary syndromes. 

    To view Abdulrhman Alghamdi's publications, visit PubMed

    Dr. Richard Body

    About the Creator

    Richard Body, MB ChB, MRCSEd (A&E), FRCEM, PhD, is an emergency medicine professor and honorary consultant in emergency medicine at the University of Manchester in the UK. He is also the founder of the Manchester Acute Coronary Syndromes (MACS) Academic Group and the Manchester Emergency Medicine and Intensive Care Research Group (EMERGING). Dr. Body’s primary research is focused on early diagnosis of acute coronary syndromes.

    To view Dr. Richard Body's publications, visit PubMed

    Are you Dr. Richard Body? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    • Govind Oliver, MD
    About the Creator
    Abdulrhman Alghamdi
    Dr. Richard Body
    Are you Dr. Richard Body?
    Content Contributors
    • Govind Oliver, MD