ADAPT Algorithm for Cardiac Event Risk
A simplified model to indicate the risk of a major adverse coronary event (MACE)

Clinical indication
The Calculator is intended to be used for patients presenting to the Emergency Department with Chest Pain aged 18 years or older.
Research authors: Martin Than, Louise Cullen, Sally Aldous, William A. Parsonage, Christopher M. Reid, Jaimi Greenslade, Dylan Flaws, Christopher J. Hammett, Daren M. Beam, Michael W. Ardagh, Richard Troughton, Anthony F. T. Brown, Peter George, Christopher M. Florkowski, Jeffrey A. Kline, Frank Peacock, Alan S. Maisel, Swee Han Lim, Arvin Lamanna, A. Mark Richards
Version: 2.5
V-2.5-158.24.05.31
(01)08719327522721(8012)v2.5(4326)240531(240)158
Download the User manual for Medical device prediction models and consult the Intended purpose.

Calculate the result

Set more parameters to perform the calculation

30-day risk of MACE is %

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Conditional information

It should be noted that, while the ADAPT can be used with contemporary cardiac troponin assays, it performs better with high-sensitivity cardiac troponin assays (hs-cTn), especially for the Fairly Low Risk category.

In the derivation study of Than et al. (2012) using contemporary (not high-sensitivity) troponin assays (Abbott ARCHITECT cTnI assay and DxI Access Accu cTnI assay)
Low Risk: 1 out of 392 patients had a Major Adverse Cardiac Event within 30 days (0.26% risk)
Fairly Low Risk: 8 out of 367 patients had a Major Adverse Cardiac Event within 30 days (2.18% risk)
High Risk: 293 out of 1216 patients had a Major Adverse Cardiac Event within 30 days (24.1% risk)

In a Validation study by Cullen et al. (2013) using the ARCHITECT High Sensitive STAT Troponin-I assay
Low Risk: 0 out of 550 patients had a Major Adverse Cardiac Event within 30 days (0% risk)
Fairly Low Risk: 3 out of 479 patients had a Major Adverse Cardiac Event within 30 days (0.63% risk)
High Risk: 400 out of 1515 patients had a Major Adverse Cardiac Event within 30 days (26.4% risk)

A pooled analysis of multiple studies containing 3163 patients with a total of 487 events found a sensitivity of 99.79% and a negative predictive value of 99.86% for the Low Risk category

A pooled analysis of multiple studies exclusively using hs-cTn assays containing 4021 patients with a total of 646 events found a sensitivity of 99.23% and a negative predictive value of 99.68% for the combined categories of Low Risk and Fairly Low Risk.

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Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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