BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and Ⅱ,respectively). METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value. RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6％;95％confidence interval[95％CI]:27.7％-33.8％)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I andⅡ were 1.3％(5/399)and 1.0％(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8％(95％CI:97.2％-99.6％)and 98.7％(95％CI:97.0％-99.5％)for MACE I and 98.7％(95％CI:96.8％-99.7％)and 99.0％(95％CI:97.4％-99.6％)for MACE Ⅱ,respectively. CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated low-risk patients remained above the level acceptable for early discharge without further evaluation.

Purpose: Research on the relationship between diet and dementia among Koreans are lacking. This study investigated the association between dietary habits and dementia progression over 3 years in patients with Alzheimer’s disease dementia (ADD). Materials and Methods: This study included 705 patients with mild-to-moderate ADD. Dietary habits were assessed using the Mini Dietary Assessment Index, comprising 10 questions. Outcome measures included the Clinical Dementia Rating scale-Sum of Boxes (CDR-SB), Seoul-Instrumental Activities of Daily Living, Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI), and neuropsychological test battery (NTB) z-scores, which were evaluated annually over 3 years. Results: In Q10 (eat all food evenly without being picky), the 3-year mean differences in CDR-SB (increases in scores represent worsening) compared to the “rarely” group were -1.86 [95% confidence interval (CI)=-3.64 – -0.09, p=0.039] for the “usually” group and -2.23 (95% CI=-4.40 – -0.06, p=0.044) for the “always” group. In Q7 (add salt or soy sauce to food when eating), the 3-year mean differences in CDR-SB compared to the “always” group were -2.47 (95% CI=-4.70 – -0.24, p=0.030) for the “usually” group and -3.16 (95% CI=-5.36 – -0.96, p=0.005) for the “rarely” group. The “rarely” and “usually” groups in Q7 showed significantly less decline in NTB z-score and CGA-NPI compared to the “always” group. Conclusion Eating a balanced diet and reducing salt intake were associated with a slower decline in dementia severity, cognition, and behavioral alterations in patients with ADD.

Background and Objectives: The History, Electrocardiography, Age, Risk factors, and Troponin (HEART) pathway was developed to identify patients at low risk of a major adverse cardiac event (MACE) among patients presenting with chest pain to the emergency department. Methods: We modified the HEART pathway by replacing the Korean cut-off of 25 kg/m2 with the conventional threshold of 30 kg/m2 in the definition of obesity among risk factors. The primary outcome was a MACE within 30 days, which included acute myocardial infarction, primary coronary intervention, coronary artery bypass grafting, and all-cause death. Results: Of the 1,304 patients prospectively enrolled, MACE occurred in 320 (24.5%). The modified HEART pathway identified 37.3% of patients as low-risk compared with 38.3% using the HEART pathway. Of the 500 patients classified as low-risk with HEART pathway, 8 (1.6%) experienced MACE, and of the 486 low-risk patients with modified HEART pathway, 4 (0.8%) experienced MACE. The modified HEART pathway had a sensitivity of 98.8%, a negative predictive value (NPV) of 99.2%, a specificity of 49.0%, and a positive predictive value (PPV) of 38.6%, compared with the original HEART pathway, with a sensitivity of 97.5%, a NPV of 98.4%, a specificity of 50.0%, and a PPV of 38.8%. Conclusions When applied to Korean population, modified HEART pathway could identify patients safe for early discharge more accurately by using body mass index cut-off levels suggested for Koreans.