Randomised controlled trial of the LoDED (Limit of Detection of Troponin and ECG Discharge) strategy versus usual care in adult chest pain patients attending the Emergency Department

orth Bristol NHS Trust0 sites632 target enrollmentApril 23, 2018

Overview

2020 Results article in https://pubmed.ncbi.nlm.nih.gov/32371401/ results (added 21/05/2020) 2018 Protocol article in https://pubmed.ncbi.nlm.nih.gov/30282688/ (added 17/08/2022) 2020 Results article in https://pubmed.ncbi.nlm.nih.gov/33298603/ Patients' and health professionals' perceptions (added 31/08/2023)

Registry

who.int

Start Date

April 23, 2018

End Date

April 3, 2019

Last Updated

2 years ago

Study Type

Interventional

Sex

All

Sponsor

orth Bristol NHS Trust

•1\. Age \=18 years
•2\. Presenting to ED with chest pain and triggering the chest pain investigation pathway i.e. treating clinician intends to perform investigation to rule out a cardiac cause
•3\. Peak symptoms occurred \<6 hours prior to presentation to the ED

•1\. ST\-elevation myocardial infarction or ischaemic ECG (new T wave inversion \> 3mm or ST depression \> 1mm) as judged by the treating clinician
•2\. Clear non\-ACS cause for chest pain found at presentation (e.g. pulmonary embolism, pneumonia, aortic dissection)
•3\. Initial hs\-troponin result known to the treating clinician
•4\. Hospital admission indicated due to other medical/social reasons
•5\. Chest pain due to arrhythmia (new\-onset atrial fibrillation, atrial flutter, sustained supraventricular tachycardia, second\-degree or complete heart block, or sustained or recurrent ventricular arrhythmias)
•6\. Unable to provide written informed consent (lacks capacity)
•7\. Unwilling to provide written informed consent
•8\. Pain too severe to provide written informed consent
•9\. Follow\-up will be impossible i.e. lives abroad or no fixed abode
•10\. Previous inclusion in the study