Study population
The 2DSPER was a prospective multicenter blinded study conducted by the
Israeli Echo Research Group.15 Patients over the age
of 45 who presented to the ED with chest pain and suspected ACS were
enrolled from 11 Israeli medical centers participating in the study
between September 2010 and February 2014. Patients were excluded if they
had ≥1mm ST segment deviation, elevated initial troponin, previous
myocardial infarction or coronary bypass surgery, other than normal
sinus rhythm, complete left bundle brunch block, moderate or severe
valvular heart disease or cardiomyopathy.
Patients were diagnosed as having ACS based on the clinical presentation
and evidence of myocardial ischemia on stress ECG, stress
echocardiography or scintigraphy and/or in the presence of a culprit
lesion (≥70 stenosis in a major coronary artery) on coronary computed
tomography angiography (CCTA) or invasive coronary angiography.
The study was approved by the local institutional review board of each
participating center and all patients signed an informed consent form.