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This retrospective review of 79 040 patients found that noninvasive cardiac testing within 72 hours of emergency department discharge of patients being evaluated for acute coronary syndrome and negative (< 0.5) troponin levels experienced a slight decreases in death and myocardial infarction. Comment: The authors note that the absolute risks of an adverse cardiac event within 30d of discharge was about 0.5% overall. Early noninvasive cardiac testing had a very small benefit, reducing the risk to about 0.3% with a number needed to treat of 250. The benefit of early noninvasive testing did not appear to be due to a change in catheterization rates but due to improved outpatient follow-up. Note that about 45% of the noninvasive cardiac tests were exercise treadmill tests, about 35% nuclear stress tests, 20% stress echo tests, and 0.1% were cardiac CT angiograms. JAMA Intern Med . 2020 Oct 5    (retrieved Oct, 2020). There are currently 1090 pearls in the database. While every attempt has been made to ensure accuracy, mistakes can and do occur. Use databank at your own risk. All pearls © 2024 by the Internet Medical Association. Click Here to view more medical pearls.