The AI program has the potential to make a real difference in often overwhelmed emergency departments.
The study results show that with ARTEMIS, twice as many patients can be confidently sent home, as opposed to using the criteria of the European Society of Cardiology (ESC) or the American College of Cardiology (ACC).
Chest pain is one of the main symptoms of a heart attack and the most common reason, in every country, for admission to a hospital's emergency department. But only 5%-25% of these patients have an acute heart attack that requires immediate treatment. Other diagnoses behind the complaints include spinal complaints or muscular tension, heartburn, a stomach hernia, or a pulmonary embolism.
The ESC and ACC guidelines recommend measuring high-sensitivity cardiac troponin-T (hs-cTn) to rule out an acute coronary event.
With the combination of the troponin rapid test and ARTEMIS program, researchers ruled out a heart attack in 35.1% of the patients, with a high negative predictive value of 99.96% and a sensitivity of 99.68%. For Type 1 myocardial infarction, both values were 100%. Only 0.05% of acute heart attacks and 0.07% of heart attacks in the following 30 days were missed.
ARTEMIS achieved exclusion rates well above those of traditional diagnostic criteria. For comparison, Toprak and her team also applied the cutoff values of the two major cardiology societies to the patient cohort. Using the ESC criteria, a heart attack was ruled out for 15.2% of patients, and with the ACC criteria, for 13.8%.
Even among the 806 patients who presented to the emergency department within 3 hours of symptom onset, the ARTEMIS program allowed for the safe exclusion of a heart attack in 153 (19%) of the cases.
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