Body R, Carlton E, Sperrin M, et al. Troponin-only Manchester Acute Coronary Syndromes (T-MACS) decision aid: single biomarker re-derivation and external validation in three cohorts. Emerg Med J. 2016; Epub ahead of print.

Greenslade JH, Nayer R, Parsonage W, et al. Validating the Manchester Acute Coronary Syndromes (MACS) and Troponin-only Manchester Acute Coronary Syndromes (T-MACS) rules for the prediction of acute myocardial infarction in patients presenting to the emergency department with chest pain. Emerg Med J. 2017;

Dr. Richard Body

//outputs
var calc_output = [];

//user inputs
var ecg = parseFloat(ecg);
var ang = parseFloat(ang);
var pnrad = parseFloat(pnrad);
var vomit = parseFloat(vomit);
var sweat = parseFloat(sweat);
var hypo = parseFloat(hypo);

var tnt = parseFloat(tnt);

if (UOMSYSTEM == true) {
	tnt = tnt * 1000
}

//calculation
var u = 1 / (1 + Math.exp(-(1.713*ecg + 0.847*ang + 0.607*pnrad + 1.417*vomit + 2.058*sweat + 1.208*hypo + 0.089*tnt - 4.766)));
u = u.toFixed(2)
risk_acs = u * 100

//results
var risk, msg
if (u < 0.02){
	risk = 'Very low';
	msg = 'ACS ruled out. Consider discharge.';
}else if ( u >= 0.02 && u < 0.05){
	risk = 'Low';
	msg = 'Consider serial troponin in ED ward, e.g. 3h troponin; consider discharge if normal.';
}else if ( u >= 0.05 && u < 0.95){
	risk = 'Moderate';
	msg = 'Serial troponin in general ward, consider stress testing and/or CT coronary angiography.';
}else{
	risk = 'High';
	msg = 'ACS ruled in. Refer to cardiology, treat for ACS.';
}

//result for user
calc_output.push({
	name: 'mini',
	value: risk,
	value_text: 'risk',
	message: risk_acs + '% risk for ACS'
});
calc_output.push({
	name: 'Risk',
	value: risk,
	value_text: 'risk',
	message: msg
});
calc_output.push({
	name: 'Score',
	value: risk_acs.toFixed(0),
	value_text: '%',
	message: 'Risk of ACS or MACE in 30 days'
});



Troponin-only Manchester Acute Coronary Syndromes (T-MACS) Decision Aid

pnrad

vomit

sweat

hypo

<p>Rules out acute coronary syndrome.</p>

T-MACS

<p>Hyunjoo Lee, MD, is a clinical assistant professor in emergency medicine at Stony Brook University Hospital. Born and raised in New York, she left New York for her undergraduate studies at Swarthmore College where she received a BA in Biology. She returned to New York and did research in B-cell biology and CLL before heading back to school to obtain her MD from Stony Brook University School of Medicine. She completed her emergency medicine residency at Mount Sinai Beth Israel in New York City and a medical education fellowship in the department of emergency medicine at Thomas Jefferson University in Philadelphia.</p>

Hyunjoo Lee, MD

The Troponin-only Manchester Acute Coronary Syndromes (T-MACS) Decision Aid rules out acute coronary syndrome.

hs-cTnT

TIMI Score for UA/NSTEMI

CCS Angina Grade

Framingham Risk Score (Hard Coronary Heart Disease)

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Calc Function