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    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
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    Patent Pending

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

    Rules out acute coronary syndrome.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with chest pain that may be cardiac in nature.

    • The T-MACS Decision Aid predicts acute coronary syndrome (ACS) or 30-day major adverse cardiac events (MACE) in patients with suspected cardiac chest pain.
    • 30-day MACE was defined as acute myocardial infarction (AMI), death, or coronary revascularization.
    • Uses high sensitivity cardiac troponin T (hs-cTnT), along with subjective symptoms and objective signs to risk stratify chest pain patients with suspected cardiac chest pain.
    • Uses a single hs-cTnT measurement on arrival, not serial values like other chest pain scores.
    • Inclusion and exclusion criteria differed slightly between the derivation and validation sets, e.g. chest pain within 12 vs. 24 hours of onset; age limits 16 vs. 18 vs. 25 years old.

    Point to Keep in Mind:

    • Remember, hs-cTNT is also a low-specificity troponin. While it may suggest ACS in high-risk patients, it can be elevated for many other reasons besides acute coronary syndromes. See Evidence for differential diagnoses.
    • Can essentially rule OUT ACS in very low risk patients.
    • Can essentially rule IN ACS in high risk patients.
    • Can avoid costly hospital admissions or risk of harm from invasive tests in patients predicted not to have ACS or risk of 30-day MACE.
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    µg/L

    Result:

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    Next Steps
    Evidence
    Creator Insights
    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

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    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.
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