Key result
Undetectable hs-TnT linked to 1.3% 30-day MACE rate vs. 15% with detectable levels.
Why the study?
The safety and efficiency of using the limit of detection of high-sensitivity troponin T as a gatekeeper for coronary computed tomography angiography in suspected ACS patients in the emergency department was not characterized.
Does an undetectable high-sensitivity troponin T level safely rule out 30-day MACE and reduce the need for CCTA in suspected ACS patients in the emergency department?
Population
177 suspected ACS patients in the emergency department undergoing CCTA
Comparison
hs-TnT value below the limit of detection vs at or above the limit of detection
Design
Cohort study
Follow-up
30-day
Authors
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LoD hs-TnT gating of CCTA appears feasible in ED suspected ACS; hypothesis-generating and requires prospective validation before practice change.
Cohort (n=177)
Does an undetectable high-sensitivity troponin T level safely rule out 30-day MACE and reduce the need for CCTA in suspected ACS patients in the emergency department?
Absolute Event Rate: 1.3% vs 15%
Using the limit of detection of hs-TnT as a gatekeeper is safe and may reduce the need for CCTA in patients with suspected ACS in the emergency department.
Arslan et al. (2021) conducted a cohort in suspected acute coronary syndrome (ACS) (n=177). hs-TnT below the limit of detection (LoD) vs. hs-TnT at or above the LoD was evaluated on 30-day major adverse cardiac events (MACEs), defined as all-cause mortality, ACS, or coronary revascularization. An hs-TnT value below the limit of detection was associated with a 1.3% rate of 30-day MACEs compared to 15% in patients with levels at or above the limit of detection.
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