Impact of high-sensitivity cardiac troponin on use of coronary angiography, cardiac stress testing, and time to discharge in suspected acute myocardial infarction
Authors' conclusion
The clinical introduction of hs-cTn does not lead to an increased or inappropriate use of coronary angiography. Introduction of hs-cTn is associated with an improved rule-out process and thereby reduces the need for stress testing and time to discharge.
Study context
- Population
- Patients presenting to the emergency department (ED) with symptoms suggestive of acute myocardial infarction (AMI)
- Participants
- 2,544 patients
- Exposure
- After vs before clinical introduction of high-sensitivity cardiac troponin T (hs-cTnT)
- Aftern = 1,089
- Beforen = 1,455reference
- Outcome
- Use of coronary angiography, stress testing, and time to discharge
Main finding
As reported in the abstract
Coronary angiography, stress testing and time to discharge
Coronary angiography
P = 0.092
Angiographies with no stenosis
P = 0.361
Stress testing
P < 0.001
Observational data: associations, not effects.
Further findings
Clinical discharge diagnosis
AMI
P < 0.001
Unstable angina
P = 0.007
Mean total costs (outpatients)
- Decreased by 20% after hs-cTnT introduction
- P = 0.002
Original publication
Impact of high-sensitivity cardiac troponin on use of coronary angiography, cardiac stress testing, and time to discharge in suspected acute myocardial infarction. Eur Heart J. Published 29 June 2016. doi:10.
Summarised from the published abstract; every number is checked against it