Key result
An accelerated 0/1-hour hs-cTnT protocol did not significantly differ from a 0/3-hour protocol for all-cause mortality or new/recurrent MI (3.8% vs 5.0%; HR 1.32; 95% CI 0.95-1.83; P=0.100).
Why the study?
The economic impact of an accelerated 0/1-hour high-sensitivity troponin-T protocol in patients presenting with suspected ACS was not well understood.
Does a 0/1-hour hs-cTnT protocol reduce costs or improve clinical outcomes compared to a conventional 0/3-hour protocol in patients with suspected ACS?
RCT (n=3,265)
randomised
Does a 0/1-hour hs-cTnT protocol reduce costs or improve clinical outcomes compared to a conventional 0/3-hour protocol in patients with suspected ACS?
Hazard Ratio: 1.32 (95% CI 0.95–1.83)
Absolute Event Rate: 3.8% vs 5%
p-value: p=0.100
An accelerated 0/1-hour hs-cTnT protocol for suspected ACS reduced ED length of stay but did not significantly reduce overall 12-month healthcare costs or improve clinical outcomes compared to a 0/3-hour protocol.
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No significant 12-month outcome difference despite shorter ED stay; extends evidence for accelerated protocols without confirming clinical or cost gains.
Chuang et al. (2021) conducted an RCT in suspected acute coronary syndrome (ACS) (n=3,265). 0/1-hour high-sensitivity troponin-T (hs-cTnT) protocol vs. conventional 0/3-hour standard-of-care protocol was evaluated on all-cause mortality or new/recurrent myocardial infarction (HR 1.32, 95% CI 0.95-1.83, p=0.100). An accelerated 0/1-hour hs-cTnT protocol did not significantly differ from a 0/3-hour protocol for all-cause mortality or new/recurrent MI (3.8% vs 5.0%; HR 1.32; 95% CI 0.95-1.83; P=0.100).
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