In January 2008, 1 EUR equalled 9.36 SEK. Unless stated otherwise, results are given as

mean ± SEM. Myocardial scintigraphy All patients underwent acute MPI after intravenous administration of a body-weight adjusted dose (7.5 MBq/kg) of 99mTc-tetrofosmin (MyoviewTM, GE Health care Life Sciences, Stockholm, Sweden) administered immediately after TAK-875 clinical trial inclusion at the ED by personnel from the Division of Clinical Physiology. Electrocardiogram-gated Inhibitors,research,lifescience,medical (eight frames) single-photon emission computed tomography (SPECT) images were obtained in the supine position with a dual-head gamma camera (Vertex, ADAC Laboratories, Milpitas, CA, USA) according to a standardised clinical protocol. In short the acquisition was performed approximately 60–120 minutes after tracer Inhibitors,research,lifescience,medical injection, using a dual-head gamma camera with high-resolution, parallel-hole collimators. Data were collected at 32 projections over a 180 degree orbit, 40 seconds per projection, and 64 × 64 matrix

zoomed to a pixel size of 5 mm. Attenuation correction was not used. SPECT images were reconstructed and post-filtered (Butterworth order, 5.0; cut-off fre quency, 0.6). The SPECT reconstruction and reorientation were Inhibitors,research,lifescience,medical automatically performed using Autospect plus (ADAC Laboratories), however, an experienced operator manually made corrections, if needed. The images were analysed in AutoQuant 4.3.1 (ADAC Laboratories). The images were interpreted by two physicians in consensus after patients were discharged from hospital and blinded to all clinical data and the discharge diagnosis. In this clinical setting a high sensitivity is required. Therefore, perfusion images had to be homogenous with no perfusion defects or Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical attenuation artifacts, and EF and LV volumes had to be normal, in order for the scan to be read as normal. Economy The hospital-related costs for each patient including all diagnostic procedures were

retrieved from USiL’s computerized economy system (PKS). All costs were the actual costs at the time of patient inclusion. The total cost of care and diagnostic work-up for each patient, excluding the cost for Edoxaban the study MPI, was considered to represent the cost of the current diagnostic practice. The cost of this approach was then compared to the cost of a theoretical management strategy where the same patient’s MPI result was accessible to the ED physician and where the patient would have been discharged home from the ED directly after a non-pathological MPI result. For this theoretical strategy (“MPI strategy”) the cost was postulated to be the total cost, including the cost of MPI, minus the cost of all in-hospital care and diagnostic tests performed after the ED. Length of stay and diagnosis at discharge were retrieved from USiL’s computerized patient records systems (Melior, Siemens/PASIS, TietoEnator).