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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

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Authors

Edward Watts Carlton

Jenny Ingram

Hazel Taylor

Joel Glynn

Rebecca Kandiyali

Sarah Campbell

Lucy Beasant

Shahid Aziz

Peter Beresford

Jason Kendall

Adam Reuben

Jason E Smith

Rebecca Chapman

Siobhan Creanor

Jonathan Richard Benger



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.

Citation

Carlton, E. W., Ingram, J., Taylor, H., Glynn, J., Kandiyali, R., Campbell, S., …Benger, J. R. (2020). Limit of detection of troponin discharge strategy versus usual care: Randomised controlled trial. Heart, 106(20), 1586-1594. https://doi.org/10.1136/heartjnl-2020-316692

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 Mar 28, 2024
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

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