Abstract

Chest pain is the second most common reason people visit the emergency room. One of the main goals of the emergency room examination is to rule out myocardial infarction when a patient presents with chest pain or other comparable anginal symptoms. The present review aimed to provide an evidence-based assessment of troponin’s usefulness in diagnosing non-ST-elevation myocardial infarction (NSTEMI) in emergency rooms. The preferred reporting items for systematic reviews and meta-analyses guidelines were followed in conducting this investigation. The CINAHL, Embase, Cochrane, and PubMed databases were considered for this review. We included studies published between 2010 and 2024 that involved adult patients suspected of having NSTEMI and admitted to emergency departments. Hospitalized patients with chest pain may have elevated cardiac troponin (cTn) levels in the absence of acute coronary syndrome (ACS). Because elevated troponin levels alone may necessitate an expensive workup and increased utilization of hospital resources, they should not be solely relied upon to diagnose ACS. A 0- and 3-hour serial ms-cTnI sampling approach is not less effective than an NSTEMI rule-out strategy employing a combined Us-Cop and ms-cTnI sampling method. Patients who have been ruled out for NSTEMI may thus be discharged early.
The hsTnI or cardiac troponin I (cTnI) levels of a patient 3 hours after arrival may aid in the early exclusion of acute myocardial infarction (AMI). Additionally, a sequential change in hsTnI or cTnI levels from admission to 3 hours post-admission may facilitate the early identification of AMI.

Key words: Diagnostic accuracy, Non ST elevation myocarditis infarction, emergency department, cardiac troponin