Key result
More sensitive cTnI cuts prolonged ED stays ~61% but increases admissions without reducing 30-day MACE.
Why the study?
More sensitive troponin assays have the potential to better evaluate patients with suspected ACS but may lead to avoidable diagnostic testing.
Does a more sensitive cardiac troponin I assay alter resource utilization and improve clinical outcomes in patients with acute chest pain presenting to the ED?
Population
1201 consecutive patients with acute non-traumatic chest pain or ischemic symptoms suggestive of ACS
Comparison
More sensitive cTnI assay vs previous cTnI assay
Design
Pre-post cohort study
Follow-up
30 days
Authors
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May shorten ED stays and reduce admissions in chest pain; leaves open long-term safety and generalizability.
Cohort (n=1,201)
Does a more sensitive cardiac troponin I assay alter resource utilization and improve clinical outcomes in patients with acute chest pain presenting to the ED?
Odds Ratio: 0.61 (95% CI 0.27–1.37)
Implementing a more sensitive troponin assay in the ED reduced length of stay for discharged patients but increased hospitalizations and downstream procedures without significantly reducing 30-day MACE.
Wang et al. (2019) conducted a cohort in acute non-traumatic chest pain or equivalent ischemic symptoms suggestive of ACS (n=1,201). More sensitive cardiac troponin I (cTnI) assay vs. Previous cTnI assay was evaluated on incidence of major adverse cardiac events (MACE) at 30 days (OR 0.61, 95% CI 0.27-1.37). Implementation of a more sensitive cardiac troponin I assay shortened emergency department length of stay (OR 0.39; 95% CI 0.28-0.54) but increased hospitalizations without reducing 30-day MACE.
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