Acute Coronary Syndrome Clinical Trial
Official title:
Introduction of an 1-hour Algorithm for High-sensitivity Cardiac-specific Troponin T for Faster Assessment of NSTEMI in a Low-prevalence Population at Oslo Accident and Emergency Outpatient Clinic
This study aims to evaluate if the 1-hour rule-in/rule-out algorithm for a high-sensitivity cardiac troponin T (hs-cTnT) is safe and effective for use in the primary care where the patients have a lower pretest probability of an acute myocardial infarction (MI). During this study troponins will be collected at 0-, 1- and 4/6-hours, where absolute changes in the values will decide whether the patient need hospitalization or not.
Many patients seek Oslo Accident and Emergency Outpatient Clinic (OAEOC) with chest pain. The
majority of these patients have symptoms suggestive of a benign non-cardiac chest pain. These
patients do not need a directly transfer to the hospital, but can be admitted to the
Observation Unit at the OAEOC for further pre-hospital testing, including serial troponins
for a safe rule-out of acute MI. The main goal of this study is to improve the current
routine at the Observation Unit at OAEOC by introducing the 1-hour algorithm for hs-cTnT for
a faster rule-in/rule-out of acute MI.
All recruited patients will have serial troponins drawn at 0, 1- and 4/6 hours, with the main
hypothesis that the absolute changes within 1 hour can be used as surrogates for the changes
and conclusions drawn after 4/6 hours. The cut-off levels used within the 0/1-hour algorithm
are assay specific as specified in the 2015 European Society of Cardiology Guidelines for the
management of acute NSTEMI.
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