Continued 32 Short Title: PM-16: Early Troponin Measurement After NSTEMI PM-16: Acute NSTEMI: Early Cardiac Troponin Measurement (Within 6 Hours of Arrival) Measure Description: Percentage of patients, age 18 y, hospitalized with acute NSTEMI, who have cardiac troponin biomarkers measured within 6 h of hospital arrival. Numerator Patients with acute NSTEMI who have at least 1 set of cardiac troponin biomarkers, measured by central laboratory troponin assays and excluding point-of-care assays in the ED or elsewhere, within 6 h of hospital arrival Denominator All patients with acute NSTEMI Denominator Exclusions Patients age <18 y Patients who leave against medical advice shortly after arrival (<6 h) Patients who die during hospitalization shortly after arrival (<6 h) Patients who are on comfort measures/hospice only documented shortly after arrival (<6 h) Patients who are transferred to another hospital for inpatient care shortly after arrival (<6 h) Patients received in transfer from the inpatient, outpatient, or ED of another facility Patients discharged shortly after arrival (<6 h) Denominator Exceptions None Measurement Period Encounter Sources of Data Medical record or other database (eg, administrative, clinical, registry) Attribution Measure reportable at the facility or provider level Care Setting Inpatient Rationale Troponins are components of the myocardial cell contractile apparatus. When measured in the circulation, they are very sensitive and specific to diagnose myocardial necrosis. In the correct clinical setting (eg, angina/ischemic symptoms, ischemic changes on the ECG, imaging evidence of ischemia), a pattern of rise and fall in troponin I or T levels is essential to the diagnosis of AMI. Although STEMI is usually readily diagnosed by the presence of acute current of injury on the presenting ECG, patients with NSTE-ACS can present with nonspecific changes on the ECG (eg, subtle or nonspecific ST or T wave changes). 