Diagnosis and Treatment of ACS in the ED: The Impact of Rapid Bedside cTnI Testing on Outcomes
| Status: | Completed |
|---|---|
| Conditions: | Angina, Angina |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 21 - Any |
| Updated: | 2/7/2018 |
| Start Date: | December 2004 |
| End Date: | March 2007 |
Diagnosis and Treatment of Acute Coronary Syndromes in the Emergency Department: The Impact of Rapid Bedside cTnI Testing on Outcomes
In a randomized, controlled clinical trial, point-of care testing at the bedside using the
cardiac biomarker troponin I in ED patients with possible ACS will be compared to traditional
testing of this assay for myocardial necrosis obtained in the central laboratory. Our
hypothesis: point-of-care testing for troponin I will decrease the time for disposition of
patients with possible ACS in the emergency setting and decrease the time required for
administering appropriate therapies for these patients.
cardiac biomarker troponin I in ED patients with possible ACS will be compared to traditional
testing of this assay for myocardial necrosis obtained in the central laboratory. Our
hypothesis: point-of-care testing for troponin I will decrease the time for disposition of
patients with possible ACS in the emergency setting and decrease the time required for
administering appropriate therapies for these patients.
Cardiac troponin I is routinely used in the emergency department as a risk stratification
tool for detecting myocardial necrosis in patients with possible acute coronary syndrome. It
is our hypothesis that having bedside, point-of-care testing for TnI in the ED will decrease
time needed to disposition patients to home from the ED or send to the cardiac
catheterization laboratory or intensive care setting. Similarly, having point-of-care testing
in the ED should decrease the time required to deliver anti-platelet drugs such as aspirin
and glycoprotein IIb/IIIa inhibitors and anti-thrombin agents such as heparin to high risk
patients found to have a positive TnI test. This will be evaluated in a randomized,
controlled clinical trial of 2000 patients. Half will have the test performed in the ED at
the bedside (point-of-care) while the other half will receive the usual lab results obtained
from the central lab (typically requiring 1.5-2 hours to return).
tool for detecting myocardial necrosis in patients with possible acute coronary syndrome. It
is our hypothesis that having bedside, point-of-care testing for TnI in the ED will decrease
time needed to disposition patients to home from the ED or send to the cardiac
catheterization laboratory or intensive care setting. Similarly, having point-of-care testing
in the ED should decrease the time required to deliver anti-platelet drugs such as aspirin
and glycoprotein IIb/IIIa inhibitors and anti-thrombin agents such as heparin to high risk
patients found to have a positive TnI test. This will be evaluated in a randomized,
controlled clinical trial of 2000 patients. Half will have the test performed in the ED at
the bedside (point-of-care) while the other half will receive the usual lab results obtained
from the central lab (typically requiring 1.5-2 hours to return).
Inclusion criteria
- Age >21 years old
- Chest pain or other symptoms that lead to drawing cardiac bio-markers for possible ACS
diagnosis
Exclusion criteria
- Presentation with chest pain in the presence of a tachydysrhythmia (ventricular
tachycardia, supraventricular tachycardia, or rapid atrial fibrillation)
- Presentation with ECG diagnostic for STEMI
We found this trial at
4
sites
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Univ of Pennsylvania Penn has a long and proud tradition of intellectual rigor and pursuit...
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Stanford University Stanford University, located between San Francisco and San Jose in the heart of...
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