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Master Thesis

Évaluation d’une stratégie d’exclusion d’un syndrome coronarien aigu par un dosage unique de troponine de haute sensibilité : retour d’expérience du CH d’Annecy

Abstract : Troponin (Tn) is an essential biomarker in order to diagnosis or exclude ACS, from a patient admitted for chest pain, especially when the ECG does not facilitate the identification. The apparition of hypersensitive Tn, more reliable and precise than the usual Tn, has permitted to make the diagnosis of ACS earlier and to reduce the imprecision in the « grey zone » in low concentrations which previously needed additional investigations which meant increasing the average length of stay. The physicians of Annecy General hospital follow an algorithm, including an ACS exclusion threshold by the troponin I US/HS Abbott © (TnI HS) at 4 ng/L, for one only sample done at least 3 hours after the pain. Our proposition is to evaluate this strategy from a retrospective study done on over 405 patients admitted to the AED between February 1, 2015 and October 15, 2017 for chest pain, without an ECG, that helps to make the diagnosis. This evaluation is based on patients' clinical documentation in the month following their admission to the AED, by tracing specically the potential happening of coronary artery ischemic episodes. According to our study, TnI HS NPV is 100% for a 3 to 6 hours sample (median = 3h57) after pain because none of the 405 clinical patients had reported ischemic events within the month following their admission in the AED. The average time between the sample and the result by the laboratory was of 75 ± 38 minutes. This study enables to validate this diagnostic strategy of exclusion of SCA ST – proposed by the Annecy general hospital , allowing to carry out a single sample to measure the TnI HS 3h after the pain.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02441447
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Submitted on : Wednesday, January 15, 2020 - 6:32:56 PM
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Vincent Thomas. Évaluation d’une stratégie d’exclusion d’un syndrome coronarien aigu par un dosage unique de troponine de haute sensibilité : retour d’expérience du CH d’Annecy. Sciences pharmaceutiques. 2019. ⟨dumas-02441447⟩

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