The Randomised Assessment of Treatment using Panel Assay of Cardiac Markers (RATPAC) trial: A randomised controlled trial of point-of-care cardiac markers in the emergency department

Goodacre, Steve W.; Hall, Alistair S.; Bradburn, Mike; Cross, Elizabeth; Collinson, Paul; Gray, Alasdair

Abstract

Objectives: To determine whether using a point-of-care cardiac biomarker panel would increase the rate of successful discharge home after emergency department assessment, and affect the use of cardiac tests and treatments, subsequent attendance at or admission to hospital and major adverse events. Design and setting: Pragmatic multicentre randomised controlled trial in six acute hospitals in the UK. Participants: Patients attending with acute chest pain due to suspected myocardial infarction (N=2243). Interventions: Diagnostic assessment using a point-of-care biomarker panel consisting of creatine kinase, myocardial type, myoglobin and troponin I measured at baseline and 90 min compared with standard care without the point-of-care panel. Main outcome measures: The primary outcome was successful discharge home, defined as having left hospital or awaiting transport home by 4 h after attendance and no major adverse events up to 3 months. Secondary outcome measures included length of stay, use of coronary care, cardiac interventions and inpatient beds, emergency department attendances, subsequent admissions, outpatient visits and major adverse events. Results: Point-of-care panel assessment was associated with an increased rate of successful discharge (358/1125 (32%) vs 146/1118 (13%); OR 3.81, 95% CI 3.01 to 4.82; p

• Journal Article Type: Article
• Publication Date: Feb 1, 2011
• Journal: Heart
• Print ISSN: 1355-6037
• Electronic ISSN: 1468-201X
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 97
• Issue: 3
• Pages: 190-196
• DOI: https://doi.org/10.1136/hrt.2010.203166
• Keywords: RATPAC, randomised assessment, treatment, cardiac markers, point-of-care, emergency department
• Public URL: https://uwe-repository.worktribe.com/output/968482
• Publisher URL: http://dx.doi.org/10.1136/hrt.2010.203166
• Additional Information: Additional Information : These articles are written on behalf of the RATPAC research teams of which Professor Benger is a member.; Corporate Creators : The RATPAC Project Team