Curie Brief
Turn on cookies to sign in
Signing in saves your progress to your Curie account. We can only do that with cookies on — turn them on to continue.
News
A new clinical decision rule combining a five-item clinical score with a finger-prick troponin test identified patients with chest pain at low risk for acute coronary syndrome with 98.3% sensitivity. Tested across Dutch primary care practices, the tool correctly flagged nearly all heart attack cases while allowing nearly half of patients to avoid unnecessary ER referrals. The findings could reshape how GPs triage chest pain.
Chest pain in primary care is a diagnostic challenge — send too few patients to the ER and you risk missing a heart attack; send too many and you overwhelm emergency departments. A new cluster-randomised trial out of the Netherlands may offer a smarter middle ground.
Researchers tested a clinical decision rule (CDR) that pairs the Marburg Heart Score (MHS) — a five-item checklist covering age, sex, cardiovascular history, and pain characteristics — with a finger-prick high-sensitivity troponin I (hs-cTnI) test that delivers results in about 8 minutes. Based on the combined result, GPs were guided to either reassure the patient, consult cardiology, or send them straight to the ER.
The CDR performed impressively, achieving near-perfect sensitivity for both ACS and myocardial infarction, meaning it rarely missed a true cardiac event — while still allowing 45% of patients to safely skip the ER.
Why it matters: This tool could give primary care physicians a reliable, fast way to triage chest pain patients — reducing unnecessary ER visits without compromising patient safety. Wider adoption could ease pressure on emergency departments and improve care coordination across settings.
