16
Treatment
2.3.3. Chest Radiography
COR LOE
Recommendation
1 C-EO 1. In patients presenting with acute chest pain, a chest
radiograph is useful to evaluate for other potential cardiac,
pulmonary, and thoracic causes of symptoms.
2.3.4. Biomarkers
COR LOE
Recommendations
1 B-NR 1. In patients presenting with acute chest pain, serial cTn I or T
levels are useful to identify abnormal values and a rising or
falling pattern indicative of acute myocardial injury.
1 B-NR 2. In patients presenting with acute chest pain, high-sensitivity
cTn is the preferred biomarker because it enables more rapid
detection or exclusion of myocardial injury and increases
diagnostic accuracy.
1 C-EO 3. Clinicians should be familiar with the analytical performance
and the 99th percentile upper reference limit that defines
myocardial injury for the cTn assay used at their institution.
3: No
benefit
B-NR 4. With availability of cTn, creatine kinase myocardial (CK-MB)
isoenzyme and myoglobin are not useful for diagnosis of acute
myocardial injury.
