T-MACS Troponin-Only Manchester ACS Decision Aid
Single time-point decision aid combining arrival high-sensitivity troponin T (Roche) with 6 clinical features to estimate the probability of acute coronary syndrome (Body 2017). Very low risk (< 2 %) supports rule-out at presentation; ≥ 95 % rules in.
Score interpretation
T-MACS probability of ACS below 2 %.
→ Consider discharge from the ED with safety-netting and follow-up as indicated (Body 2017).
T-MACS probability of ACS 2 to < 5 %.
→ Serial troponin testing in a low-dependency area.
T-MACS probability of ACS 5 to < 95 %.
→ Further investigation including serial troponin; admission or observation per local pathway.
T-MACS probability of ACS 95 % or more.
→ Treat as acute coronary syndrome per the local pathway; urgent cardiology review.
Interpretation bands for the T-MACS. Apply clinical judgement and local guidance.
References
- Body R et al. T-MACS decision aid: single biomarker re-derivation and external validation in three cohorts. Emerg Med J. 2017;34(6):349-356.
Related
Curated clinical cross-links plus same-class fallbacks.
- HEART Score for Major Adverse Cardiac Events · Chest Pain
- EDACS — Emergency Department Assessment of Chest Pain · Chest Pain
- HEAR Score for Acute Chest Pain · Chest Pain
- ACTION ICU Score for Intensive Care in NSTEMI · Chest Pain
- Marburg Heart Score · Chest Pain
- INTERCHEST Clinical Prediction Rule · Chest Pain
- Terbinafine 1% Topical · Topical antifungal (allylamine)
- Methoxyflurane · Inhaled Analgesic — Acute Pain
- Progestogen-Only Pill (POP / Mini-pill) · Progestogen-Only Contraceptive (Oral)
- Fentanyl Transdermal Patch (Elderly Chronic Pain) · Opioid Analgesic — Transdermal Patch
- Morphine Slow-Release (Elderly Chronic Pain) · Opioid Analgesic — Modified-Release Oral
- Lamivudine with tenofovir disoproxil and doravirine · NRTI/NRTI/NNRTI single-tablet regimen
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.