Modest Changes in Practice for High-Sensitivity TnT Reporting

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High-sensitivity troponin reporting alone is associated with only modest changes in practice.
High-sensitivity troponin reporting alone is associated with only modest changes in practice.

HealthDay News -- For patients presenting to the emergency department with chest pain, high-sensitivity troponin T (hs-TnT) reporting is associated with modest changes in practice, according to a study recently published online in Circulation: Cardiovascular Quality and Outcomes.1

Derek P. Chew, MBBS, MPH, from Flinders University in Adelaide, Australia, and colleagues examined the impact of hs-TnT reporting on care and outcome among patients presenting to emergency departments with chest pain. A total of 1,937 patients without ST-segment elevation were enrolled and randomized to hs-TnT reporting (hs-report) or standard reporting (std-report).

The researchers found that 75.7% of patients had maximal troponin <30 ng/L within 24 hours. The admission rate was not altered with randomization to hs-report format (hs-report: 57.7 percent versus std-report: 58.0%; P =.069). There was no between-group difference in angiography (hs-report: 11.9% versus std-report: 10.9%; P =.479). There was no reduction in 12-month death or new-recurrent acute coronary syndrome in the overall population with hs-report (hs-report: 9.7% vs std-report: 7.2%; P =.362). There was a modest reduction in the primary end point among those with troponin levels <30 ng/mL (hs-report: 2.6% vs std-report: 4.4%; P =.050).

"High-sensitivity troponin reporting alone is associated with only modest changes in practice," the authors write. "Clinical effectiveness in the adoption of high-sensitivity troponin may require close coupling with protocols that guide interpretation and care."

Several authors disclosed financial ties to the pharmaceutical industry.

Reference

  1. Chew DP, Zeitz C, Worthley M, et al. Randomized Comparison of High-Sensitivity Troponin Reporting in Undifferentiated Chest Pain Assessment. Circ Cardiovasc Qual Outcomes. 2016.
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