Evaluation of Serial Troponin and Cardiac Multimarkers at the Point of Care in the Emergency Department

Inclusion Criteria:

- 18 years of age or older at time of enrollment

- Presenting to the ED within 6 hours from onset of chest discomfort (pain, pressure,
tightness, etc) consistent with a possible diagnosis of AMI or ACS and with an
initial ECG non-diagnostic for injury (or injury equivalent resulting in emergent
reperfusion therapy). (NOTE: Subjects who have chest discomfort that is episodic or
stuttering in nature may be included if the ED presentation is within 6 hours of
symptom onset.)

- Experiencing at least 30 minutes of chest pain or other anginal equivalent symptoms.
(Note: Subjects who have symptoms of shorter duration due to pharmacologic
intervention may be included.)

Exclusion Criteria:

- Patient (or Legal Representative) unable or unwilling to provide written informed
consent.

- Patient unwilling or unlikely to comply with study procedures, including
protocol-specified blood sampling or telephone follow-up at 30 days and 6 months.

- Vulnerable populations as deemed inappropriate for study by site principal
investigator.

- ST-elevation or other ECG criteria that result that is diagnostic for AMI and results
in patient being sent for percutaneous coronary interventions (PCI) or being treated
with thrombolytics6.

- Pulmonary Edema requiring CPAP, BIPAP, or mechanical ventilation

- Tachyarrhythmias (SVT, V-Tach, rapid atrial fib)

- End Stage Renal Disease on Hemodialysis

- Cardiac Arrest prior to arrival

- Implantable Defibrillator firing prior to arrival

- Hemodynamically unstable patients

- Trauma injury to the chest