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

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


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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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