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.