Home > Cardiology > Early rule-out alogrithm for MI patients proves safe and effective

Early rule-out alogrithm for MI patients proves safe and effective

Conference
ESC 2019
Trial
HiSTORIC
Implementation of an early indicator for ruling out myocardial infarction (MI) in patients with suspected acute coronary syndrome (ACS), incorporating a single high-sensitivity cardiac troponin (hs-cTn) test at presentation with risk stratification and diagnostic thresholds, is both effective and safe. The HiSTORIC trial was a stepped-wedge cluster randomised controlled trial conducted in 7 hospitals across Scotland. Randomisation was performed at the hospital level and not per patient; this resulted in enrolment of all consecutive patients undergoing hs-cTnI testing for suspected ACS in the emergency room. MI was ruled out if hs-cTnI concentrations were <5 ng/L at presentation or between 5 ng/L and the 99thcentile with a change <3 ng/L at3hours (High-STEACS pathway). Co-primary endpoints of the study were length of stay (efficacy) and MI or cardiac death after discharge (safety) within 1 year of follow-up. A total of 31,492 patients with cTnI concen...


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