Pre-hospital rule-out of non-ST-segment elevation acute coronary syndrome by a single troponin: final one-year outcomes of the ARTICA randomised trial
Authors' conclusion
Pre-hospital rule-out of NSTE-ACS with POC troponin testing in low-risk patients is cost-effective, as expressed by a sustainable healthcare cost reduction and no significant effect on QoL. One-year MACE remained low for both strategies.
Study context
- Population
- Low-risk patients with suspected NSTE-ACSfollow-up completed for all
- Participants
- 863 patients
- Comparison
- Pre-hospital rule-out with point-of-care (POC) troponin vs emergency department (ED) transfer
- Pre-hospital strategyn = 434
- ED strategyn = 429reference
- Primary endpoint
- Healthcare costs
- Follow-up
- 1 year
Primary result
As reported in the abstract
Mean difference
717 €
95% CI €347 to €1087
P < 0.001
By group
Pre-hospital strategy vs ED strategy
mean difference 717 € (95% CI €347 to €1087); P < 0.001
Secondary outcomes
Quality of life (QoL) (EuroQol-5D-5L) · 1 year
- No significant difference between strategies
Safety
MACE (ACS, unplanned revascularization or all-cause death), total population · 1 year
P = 0.54
| Outcome | Pre-hospital strategy | ED strategy | Risk difference (95% CI) | P value | |
|---|---|---|---|---|---|
| MACE, ruled-out ACS population · 1 year | 1.7% | 1.4% | 0.2% (−1.4% to 1.9%) | P = 0.79 | |
| −2−1012Difference (linear scale) |
Original publication
Pre-hospital rule-out of non-ST-segment elevation acute coronary syndrome by a single troponin: final one-year outcomes of the ARTICA randomised trial. Eur Heart J Qual Care Clin Outcomes. Published 17 January 2024. doi:10.
Summarised from the published abstract; every number is checked against it