en Cardiology Cardiology Original Article Original Article <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="color:#0033ff;"><strong><em>Background</em></strong><em>:</em></span> Chest pain indicating acute coronary syndrome (ACS) accounts for approximately 5-10% of presents in the emergency departments (EDs). Rapid decision making is very important because longer hospital stay is associated with higher financial burden. The aim of this study was to compare current practice with a 2-hour accelerated diagnostic protocol (ADP) to manage chest pain in patients suspected to have ACS.<br> <span style="color:#0033ff;"><strong><em>Methods</em></strong><em>:</em></span> This is a longitudinal follow-up study on 900 patients with negative troponin measured on entrance to the ED and initially low-risk for myocardial infarction according to the emergency department of chest pain assessment score (EDACS) at the Loghman Hakim Hospital, Tehran, Iran in 2018. Patients were divided in two groups (based on odd or even days at admission time) at a ratio of 2:1 (i) current protocol with a second troponin measuring after 6 hours and (ii) ADP with a second troponin measured after 2 hours. Major adverse cardiac events (MACE) associated factors assessed in two groups over 30-days.<br> <span style="color:#0033ff;"><strong><em>Results</em></strong><em>:</em></span> Totally, the rate of return to EDs with the major adverse cardiac events was 4% (n=24) in the current protocol group and 1% (n=1) in the ADP group within 30 days. The odds ratio for MACE in 30 days in the current protocol was 4.3 times more than ADP group (95% CI: 1.28-14.56, OR: 4.33, p:0.02). In multivariable logistic regression analysis, this estimation for the current protocol was 4.10 times more than comparison group (95% CI: 1.23-13.81, OR: 4.10, p:0.01).<br> <span style="color:#0033ff;"><strong><em>Conclusion</em></strong><em>:</em> </span>A 2-hour ADP in patients at low-risk for myocardial infarction by EDACS had fewer adverse follow-up events than the current protocol.</span></span> <div><div id="ftn4"></div></div> <div><div id="ftn1"></div></div> Current protocol, accelerated 2h diagnostic protocol, acute coronary syndrome 148 154 http://caspjim.com/browse.php?a_code=A-10-1126-3&slc_lang=en&sid=1 Kamran Heidari kamranheydari2007@yahoo.com 100319475328460028141 100319475328460028141 Yes Skull Base Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mahbube Asghari Arani dr.ma.arani@gmail.com 100319475328460028142 100319475328460028142 No Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mehdi Sheibani mesheibani@yahoo.com 100319475328460028143 100319475328460028143 No Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences,Tehran, Iran John W Pickering john.pickering@otago.ac.nz 100319475328460028144 100319475328460028144 No Emergency Department, Christchurch Hospital and Department of Medicine, University of Otago Christchurch, New Zealand Arezoo Chouhdari chouhdariarezoo@gmail.com 100319475328460028145 100319475328460028145 No Skull Base Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran