ICare-FASTER (Improving Care by Faster Risk Stratification Through Use of High-Sensitivity Point-of-Care Troponin in Patients Presenting With Possible Acute Coronary Syndrome in the Emergency Department): A Stepped-Wedge Cluster-Randomized Trial
Authors' conclusion
Implementation of whole-blood hs-cTnI testing at the point of care into an accelerated diagnostic pathway was safe and reduced length of stay in the ED compared with laboratory testing.
Study context
- Population
- Patients presenting to the emergency department with possible myocardial infarctionEmergency department (ED) presentations (44,747 individuals), 31,392 presentations during the intervention arm, six sites · intervention arm presentations 31,392
- Participants
- 59,980 patients
- Comparison
- intervention arm vs control arm
- intervention armn = 31,392
Primary result
As reported in the abstract
ED length of stay
Control arm
376
mean length of stay · minutes
intervention arm vs control armRelative reduction in length of stay (95% CI)P value
Reduced with intervention; adjusted for covariates associated with length of stay
13%(9%–16%)
P < 0.001intervention arm vs control armReduction in length of stay, minutes (95% CI)
Reduction with intervention
47(33–61)
Further findings
Participant characteristics
- Mean age
- 61±19 years
- Female
- 49.5%
- February 2023 through January 2025
Safety
Myocardial infarction or cardiac death · 30 days · similar
P = 0.54
Original publication
ICare-FASTER (Improving Care by Faster Risk Stratification Through Use of High-Sensitivity Point-of-Care Troponin in Patients Presenting With Possible Acute Coronary Syndrome in the Emergency Department): A Stepped-Wedge Cluster-Randomized Trial. Circulation. Published 19 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it