Value of single troponin values in the emergency department for excluding acute myocardial infarction in Aboriginal and Torres Strait Islander people

atients with single high sensitivity cardiac troponin I (hs-cTnI) measurements below specified threshold values are deemed to be at low risk of acute myocardial infarction (AMI). 1- 5 The accuracy of single hs- cTnI measurements has not been investigated in Aboriginal and Torres Strait Islander people. The National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand guidelines note that Aboriginal and Torres Strait Islander patients should generally not be treated as being at low risk. 6 We evaluated the accuracy of single hs- cTnI measurements for excluding AMI in Aboriginals and Torres Strait Islanders in a planned analysis of data collected during the observational IMPACT study, which examined the assessment of potential acute coronary syndrome (ACS) in this population. We collected data for adults (18 years or older) who visited the Cairns Hospital emergency department during the 2019 calendar year and were evaluated for ACS. Patients were recruited consecutively on weekdays (8 am – 5 pm). Further details, including on cultural safety, are included in the Supporting Information. The Far North Queensland Human Research Ethics Committee approved the study (HREC/17/QCH/42– 1139). All participants received standard including electrocardiography and hs- cTnI assessments at 2– 3 hours later (hs- cTn I assay [Beckman Coulter]; limit of detection, 2.3 ng/L), as well as appropriate imaging for coronary artery disease. Thirty days later, research nurses followed up patients single early rule- out and Torres Strait patients. Our study advances understanding of ACS assessment by ensuring that our evidence the in our care