Modest Changes in Practice for High-Sensitivity TnT Reporting
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.
- 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.