Limit of detection of troponin discharge strategy versus usual care: Randomised controlled trial

Carlton, Edward Watts; Ingram, Jenny; Taylor, Hazel; Glynn, Joel; Kandiyali, Rebecca; Campbell, Sarah; Beasant, Lucy; Aziz, Shahid; Beresford, Peter; Kendall, Jason; Reuben, Adam; Smith, Jason E; Chapman, Rebecca; Creanor, Siobhan; Benger, Jonathan Richard

Abstract

Introduction The clinical effectiveness of a a € rule-out' acute coronary syndrome (ACS) strategy for emergency department patients with chest pain, incorporating a single undetectable high-sensitivity cardiac troponin (hs-cTn) taken at presentation, together with a non-ischaemic ECG, remains unknown. Methods A randomised controlled trial, across eight hospitals in the UK, aimed to establish the clinical effectiveness of an undetectable hs-cTn and ECG (limit of detection and ECG discharge (LoDED)) discharge strategy. Eligible adult patients presented with chest pain; the treating clinician intended to perform investigations to rule out an ACS; the initial ECG was non-ischaemic; and peak symptoms occurred 40% of patients with chest pain. Clinical effectiveness is variable when compared with existing rule-out strategies and influenced by wider system factors. Trial registration number ISRCTN86184521.

• Journal Article Type: Article
• Acceptance Date: Mar 30, 2020
• Online Publication Date: May 5, 2020
• Publication Date: Sep 25, 2020
• Deposit Date: Nov 2, 2021
• Publicly Available Date: Nov 2, 2021
• Journal: Heart
• Print ISSN: 1355-6037
• Electronic ISSN: 1468-201X
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 106
• Issue: 20
• Pages: 1586-1594
• DOI: https://doi.org/10.1136/heartjnl-2020-316692
• Keywords: Cardiology and Cardiovascular Medicine
• Public URL: https://uwe-repository.worktribe.com/output/8044573