Key result
Telemedicine triage using ECG and troponin linked to greater ACS detection and antiplatelet treatment.
Why the study?
Differentiating ACS chest pain from noncardiac causes remains a challenge in remote settings where prompt triage by electrocardiogram and troponin can potentially save time and life.
Does telemedicine-guided electrocardiogram and troponin triage improve acute coronary syndrome detection and management in patients presenting with chest pain in remote settings?
Observational (n=121)
No
Does telemedicine-guided electrocardiogram and troponin triage improve acute coronary syndrome detection and management in patients presenting with chest pain in remote settings?
p-value: p=<0.05
Telemedicine-assisted ECG and troponin triage in remote settings significantly improves the detection and initial management of acute coronary syndromes.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“These results highlight the potential of telemedicine to improve post-ACS patient care by enhancing clinical decision-making and reducing the need for hospital care.”
“So much of medicine has “evolved, yet our quality hasn't gotten better. We have got to figure out a different way of caring for our patients because our MI patients are not getting better. So what are we going to do differently to help move that needle?””
“The team was able to aid in preventing unnecessary presentations and advised the patients to seek emergency care whenever was necessary. The TELE-ACS protocol provided a significant reduction in readmission rates post-ACS and other adverse events.”
May aid ACS triage in remote clinics; leaves open efficacy pending randomized trials.
BACKGROUND: Due to unawareness, many patients, particularly older ones, often misattribute cardiac pain to dyspepsia, leading to delayed acute coronary syndrome (ACS) diagnosis and failure to attain timely referral in resource-limited settings. PROJECT RATIONALE: Differentiating ACS chest pain from noncardiac causes remains a challenge in remote settings where prompt triage by electrocardiogram and troponin can potentially save time and life. PROJECT SUMMARY: We conducted baseline assessments on 43 patients over 2 months (group 1) at a remote health center. After setting up electrocardiogram and troponin testing, telemedicine service for test interpretation and referral guidance was provided. Concurrently, awareness initiatives were implemented. Data collected over next 4 months on 78 patients (group 2) showed significant awareness build-up, more ACS detection with loading antiplatelet treatment, and positive patient attitude (P < 0.05). TAKE-HOME MESSAGE: It is possible to implement quality improvement initiatives in practice by utilizing existing resources properly and employing simple measures to improve patient outcomes.
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Biswas et al. (2026) conducted an observational in Acute Coronary Syndrome (n=121). Telemedicine triage by ECG and troponin testing vs. Baseline assessment without telemedicine triage was evaluated on ACS detection, loading antiplatelet treatment, and positive patient attitude (p=<0.05). Telemedicine triage using ECG and troponin testing significantly increased ACS detection, antiplatelet treatment, and positive patient attitude compared to baseline (P<0.05).
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