Rapid Acute Coronary Syndrome Exclusion Using High-sensitivity I Troponin

  • End date
    Feb 15, 2022
  • participants needed
  • sponsor
    Henry Ford Health System
Updated on 17 February 2021
cardiac troponin
acute coronary syndrome
troponin i


As part of the planned implementation of a new clinical pathway using hs-cTnI, the investigators will measure patient outcomes and clinical processes in a real-world scenario throughout an integrated health system across 9 emergency departments (ED).


This is a pragmatic, implementation study testing the implications of a real-world execution of a rapid evaluation pathway for suspected ACS using the Beckman hs-cTnI assay. As the new protocol is executed across 9 EDs within an integrated health system, the investigators will study its effects on patient and system-level metrics. A modified stepped wedge design will be utilized that allows comparison of the RACE-IT pathway with standard of care management

Condition Chest Pain, Coronary Artery Disease, Coronary heart disease, Vascular Diseases, Heart disease, Pain, Ischemic Heart Disease, Post-Surgical Pain, Pain (Pediatric), Cardiac Ischemia, Myocardial Ischemia, Cardiac Disease, pain chest
Treatment Standard of Care, RACE-IT Pathway
Clinical Study IdentifierNCT04488913
SponsorHenry Ford Health System
Last Modified on17 February 2021


Yes No Not Sure

Inclusion Criteria

Patients 18 years old presenting to the ED for whom a treating clinician suspects ACS and orders a baseline ECG and cardiac troponin

Exclusion Criteria

ST-segment Myocardial Infarction (STEMI) leading to immediate reperfusion therapy
Any ED-drawn hs-cTnI value > 99th percentile (18 ng/L)
Clear traumatic cause for symptoms (e.g., direct chest wall trauma, motor vehicle accident)
A transfer from another facility
Primary residence outside the state of Michigan
Previous inclusion in the study
Enrolled in hospice
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