Title: The ADAPT Trial
题目：仅用肌钙蛋白在2小时内评价胸痛病人的价值研究
Author 作者: Semhar Tewelde

• The ADAPT (2-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker) trial was a prospective observational validation study designed to assess a predefined ADP (Accelerated Diagnostic Protocol)
• ADAPT（应用目前肌钙蛋白做为唯一的生物指标来评估具有胸痛的病人）是一个前瞻性的观察性的论证临床研究，其目的是对一个快速诊断方案（ADP）进行评估。
• A low risk patient in this ADP was defined by TIMI 0, ECG w/no ischemic changes, and negative troponin at 0-and 2-hours after presentation
• ADP中所指的低危险病人是指在就诊时和两小时后TIMI为0，没有缺血性ECG改变，肌钙蛋白阴性。
• Primary endpoint was assessment of any major adverse cardiac event (MACE)
• 主要观察指标是对任何的显著不良心脏后果（MACE）进行分析。
• Of 1,975 patients enrolled, 302 (15.3%) had a MACE
• 在1975个病人中，有302(15.3%)出现一个MACE。
• ADP classified 392 patients (20%) as low risk and only 1 (0.25%) had a MACE
• 在392个ADP认定的低危险病人（20）中，仅有1个1病人(0.25%)有一个MACE发生。
• ADP had a sen 99.7%, NPV 99.7%, spec 23.4%, and PPV 19.0%
• ADP的敏感性为99.7%，阴性预测值 99.7%，特异性23.4%，和阳性预测值19.0%
• ADP still requires rapid early outpatient follow-up or further inpatient testing
• ADP方案还是需要快速早期的院外随诊或进一步的院内检查。

References 参考文献：
Than M, Cullen L. 2-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker. J Am Coll Cardiol. 2012;59(23):2091-2098