Burgstaller, Jakob MJakob MBurgstallerHeld, UlrikeUlrikeHeldGravestock, IsaacIsaacGravestockKlauser, Benjamin SBenjamin SKlauserGort, Laura MLaura MGortMelzer, LinaLinaMelzerHasler, SusannSusannHaslerBierreth, Tenzin DTenzin DBierrethMüller, Sarah ESarah EMüllerSteurer, JohannJohannSteurerWertli, Maria MonikaMaria MonikaWertli2024-10-282024-10-282020-08https://boris-portal.unibe.ch/handle/20.500.12422/186656BACKGROUND Compared to troponin T/I test, the introduction of a high-sensitive (hs) troponin test may result in a higher proportion of positive test results in patients with chest pain and over testing in patients without acute coronary syndrome. We assessed the impact of the introduction of the hs-troponin assay on the discharge diagnoses and the number of diagnostic tests in patients presenting with chest pain in a real-life setting in an ED. METHODS Retrospective chart review of patients presenting with chest pain to one of the largest hospitals in Switzerland. We compared the standard troponin period (12/2009 to 11/2010) to the hs-troponin period (12/2010 to 12/2011). RESULTS Data from 1,274 patients (standard 597 (46.9%), hs-troponin 677 (53.1%)) were analyzed. The proportion of patients with NSTEMI increased (hs-troponin 14.9% compared to 9.7%); the proportion in unstable angina (1.5% to 4.0%) and other cardiac illnesses (8.1% to 11.7%) decreased. Although the proportion of non-cardiac chest pain illnesses (67%) remained unchanged, the proportion of positive hs-troponin was higher (6.1% vs. 2.0%). The average number of additional tests/person decreased in troponin positive patients (2.0 to 1.7 test per patient; p=0.02) and troponin negative patients (3.1 to 2.8 tests; p<0.0001). CONCLUSION Although the introduction of the hs-troponin test resulted in a higher proportion of positive hs-troponin tests in patients with non-cardiac chest pain, the average number of diagnostic tests decreased in patients with chest pain presenting to an ED indicating an increased confidence of clinicians in their diagnosis.enTroponin test acute coronary syndrome chest pain high-sensitive troponin test non-cardiac chest pain overdiagnosis600 - Technology::610 - Medicine & healtharticle10.7892/boris.1397753198780310.1016/j.amjmed.2019.12.029