Acute Coronary Syndrome: Likelihood Ratios
Introduction: ACS is distinguished from stable angina by:
* Rest angina, which is usually more than 20 minutes in duration
* New onset angina that markedly limits physical activity
* Increasing angina that is more frequent, longer in duration, or occurs with less exertion than previous angina
ACS is divided into 3 major categories, namely unstable angina (defined by no serum marker elevation), NSTEMI (serum markers but no ST elevations), and STEMI.
STEMI (ST-segment Elevation Myocardial Infarction, aka ST-elevation MI) - Strict ECG definition: New ST elevation at the J-point in two contiguous leads with the cut-off points: >=0.2 mV in men or >=0.15 mV in women in leads V2-V3 and/or >=0.1 mV in other leads, in the absence of LVH and RBBB.
Cardiac Enzymes timecourse (sens/spec data) from Circulation PMID 10190875:
http://circ.ahajournals.org/cgi/content/full/99/13/1671/T2
Cardiac Enzymes timecourse, from UpToDate:
http://www.uptodate.com/online/content/image.do?imageKey=CARD%2F3187
Other clinical findings: JAMA. 2015 Nov 10;314(18):1955-65 PMID: 26547467 (old) JAMA. 1998 Oct 14;280(14):1256-63. PMID: 9786377
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Prevalence
| Population / Calculator | Prevalence | Comments / Study / Link |
| TIMI risk score | 12% | http://www.mdcalc.com/uanstemitimiscore
|
| 500 | 10% | |
| 0% | ||
| More, Edit... | ||
The likelihood ratios of findings for Acute Coronary Syndrome are listed below. See the left navigation bar to change the display.