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We cover the clinical policy from the American College of Emergency Physicians -\\xa0Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non\\u2013ST-Elevation Acute Coronary Syndromes

In adult patients without evidence of ST-elevation acute coronary syndrome, can initial risk stratification be used to predict a low rate of 30-day major adverse cardiac events?

• Use HEART score \\u22643\\xa0

In adult patients with suspected acute non\\u2013ST-elevation acute coronary syndromes, can troponin testing within 3 hours of emergency department presentation be used to predict a low rate of 30-day major adverse cardiac events?

• Negative conventional troponins at 0,3 hrs in low risk patients
• High sensitivity troponin: undetectable initial troponin, no need for another. Negative initial troponin, repeat at 2 hours

In adult patients with suspected acute non\\u2013ST-elevation acute coronary syndromes\\xa0in whom acute myocardial infarction has been excluded, does further diagnostic testing (eg, provocative, stress test, computed tomography [CT] angiography) for acute coronary syndrome prior to discharge reduce 30-day major adverse cardiac events?

• No need to get provocative testing before discharge or within particular time frame

Should adult patients with acute\\xa0non\\u2013ST-elevation myocardial infarction receive immediate antiplatelet therapy in addition to aspirin to reduce 30-day major adverse cardiac events?

• antiplatelet therapy additional to aspirin can be given or delayed

Thanks for listening!
Jeremy Faust and Lauren Westafer