Aiming Towards Evidence Based Interpretation of Cardiac Biomarkers in Patients Presenting With Chest Pain Using Point of Care Assays (WESTCOR-POC)

  • STATUS
    Recruiting
  • End date
    Dec 31, 2030
  • participants needed
    1500
  • sponsor
    Haukeland University Hospital
Updated on 11 May 2022
chest pain
troponin

Summary

The aim of the current study is to perform a RCT comparing safety and efficiency of a standard care (in-line with current ESC recommendations) to an algorithm that utilize a POC troponin tests for bedside measurement, the instruments could be located in the ED and return results in few minutes.

Description

Ischemic coronary artery disease is an important health challenge and a common cause of death worldwide. Patients with symptoms suggestive of acute coronary syndrome are frequently referred to the emergency department (ED) and impose a high work-load on hospitals. Since 2009, high-sensitivity cardiac troponin (hs-cTn) assays have become a crucial ED tool for differentiating between patients with and without Non-ST-elevation myocardial infarction (NSTEMI). Accordingly, the European Society of Cardiology (ESC) recommends 0-1 hour algorithms that use hs-cTn for rule-out and rule-in of NSTEMI.

Additionally, the clinical suspicion of acute coronary syndrome (ACS) or other life-threating conditions must be low.

Unfortunately, these algorithms have been difficult to implement into routine and clinical practice, and are only used by a limited number of hospitals due to lack of randomized clinical trials and practical obstacles, including turnaround time for troponins.

The aim of the current study is to perform a RCT comparing safety and efficiency of a standard care (in-line with current ESC recommendations) to an algorithm that utilize a POC troponin tests for bedside measurement, the instruments could be located in the ED and return results in few minutes.

Details
Condition Acute Coronary Syndrome
Treatment Troponin I (Siemens VTli) 0/1 hour algorithm, Troponin T (Roche Diagnostics) 0/1 hour ESC algorithm
Clinical Study IdentifierNCT05354804
SponsorHaukeland University Hospital
Last Modified on11 May 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Patients > 17 years who are referred to the Emergency Department of Haukeland University
Hospital with chest pain suspect of ACS

Exclusion Criteria

STEMI (ECG criteria)
Patients without STEMI who are immediately transferred to cardiac catheterisation lab
(due to heart failure, arrhythmia etc.) without possibility for blood sampling
Patients admitted from Nursing homes
Patients transferred from other hospitals (e.g. for PCI treatment)
Less than 2 months life expectancy from comorbid clinical conditions
Not possible to provide informed consent due to cognitive impairment, language
problems or other reasons
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