Key result
A rapid acute coronary syndrome rule-out pathway using high-sensitivity cardiac troponin I will be evaluated for safety and effectiveness in a stepped-wedge cluster randomized trial of 11,070 patients.
Why the study?
Few randomized trials have evaluated the safety and operational impact of high-sensitivity cardiac troponin assays, leaving limited evidence to guide their implementation for suspected ACS in the emergency department.
Does a rapid ACS rule-out pathway using hs-cTnI safely discharge patients with suspected ACS from the emergency department?
Population
11,070 patients in the ED with clinical suspicion for ACS
Comparison
Rapid ACS rule-out pathway using hs-cTnI vs standard care pre-implementation
Design
Prospective stepped-wedge cluster randomized implementation trial
Authors
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Does not yet change ED discharge practices for suspected ACS; this RCT will determine safety and effectiveness of hs-cTnI rule-out.
RCT (n=11,070)
stepped-wedge cluster
Yes
Does a rapid ACS rule-out pathway using hs-cTnI safely discharge patients with suspected ACS from the emergency department?
This trial protocol describes a stepped-wedge cluster randomized trial to evaluate the effectiveness and safety of a rapid hs-cTnI pathway for ruling out ACS in the emergency department.
Miller et al. (2021) conducted an RCT in suspected acute coronary syndrome (n=11,070). Rapid ACS rule-out pathway using high-sensitivity cardiac troponin I was evaluated on Effectiveness in safely discharging patients from the ED for whom clinical suspicion for ACS exists. A rapid acute coronary syndrome rule-out pathway using high-sensitivity cardiac troponin I will be evaluated for safety and effectiveness in a stepped-wedge cluster randomized trial of 11,070 patients.
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