The Use of Very Low Concentrations of High‐sensitivity Troponin T to Rule Out Acute Myocardial Infarction Using a Single Blood Test
Why the study?
Does a single hs-cTnT test below the limit of detection combined with no ECG ischemia safely rule out acute myocardial infarction in patients with suspected cardiac chest pain?
Population
1,282 patients with suspected cardiac chest pain within 6 hours of peak symptoms, multinational.
Comparison
Initial high-sensitivity cardiac troponin T… vs Serial troponin sampling over 4-14 hours.
Design
Cohort
Follow-up
30 days
Authors
Discussion
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Member takes
Implication
May support early rule-out in select patients; leaves open need for prospective validation before practice change.
Structured PICO
Does a single hs-cTnT test below the limit of detection combined with no ECG ischemia safely rule out acute myocardial infarction in patients with suspected cardiac chest pain?
P
Population
1,282 patients with suspected cardiac chest pain within 6 hours of peak symptoms, multinational (12 sites in 9 countries).
I
Intervention
Initial high-sensitivity cardiac troponin T (hs-cTnT) level below the limit of detection (LoD = 5 ng/L) and no electrocardiogram (ECG) ischemia.
C
Comparator
Serial troponin sampling over 4-14 hours.
O
Outcome
Prevalent acute myocardial infarction (AMI), adjudicated based on sensitive troponin I levels.hard clinical
A single hs-cTnT test below the limit of detection combined with a non-ischemic ECG can safely rule out AMI in about one-third of patients presenting with chest pain, potentially reducing unnecessary hospital admissions.
Cite This Study
Body et al. (2016) studied this question.