Outcome of low-risk patients discharged home after a normal cardiac troponin I

Stephen W. Smith, Carrie D. Tibbles, Fred S. Apple, Marsha Zimmerman

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13 Scopus citations


Patients with symptoms suggestive of, but at low risk for, acute coronary syndrome (ACS), who have a negative electrocardiogram (EKG) and a single normal troponin I at 6-9 h after symptom onset are frequently discharged from our Emergency Department (ED). We sought to determine their rate of adverse cardiac events at 30 days (ACE-30), defined as cardiac death or myocardial infarction (MI), by chart review, telephone interview, or county death records. Of 663 patients, data were available for 588 (89%). Mean age was 48 years; 59% were male. There were 390 patients (66%) who complained of chest pain. Previous coronary artery disease (CAD) was reported in 145 patients (25%). Two patients (0.34%) had ACE-30, both with non-ST elevation MI. There were no cases of cardiac death. None of the patients died in Hennepin County within 30 days. At our institution, low-risk patients with symptoms suggestive of ACS who are discharged home after a normal cTnI drawn 6-9 h after symptom onset have a very low incidence of cardiac events at 30 days.

Original languageEnglish (US)
Pages (from-to)401-406
Number of pages6
JournalJournal of Emergency Medicine
Issue number4
StatePublished - May 2004


  • Acute coronary syndrome
  • Chest pain
  • Discharge to home
  • Myocardial infarction
  • Troponin


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