A randomised controlled trial of point-of-care cardiac markers in the emergency department

Completed

• Conditions: Chest pain due to suspected but not proven AMI; Circulatory System; Acute Myocardial Infarction

• Registration Number: ISRCTN37823923
• Lead Sponsor: niversity of Sheffield (UK)

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2007-02-01
• Last Update Posted: 13 January 2015

Recruitment & Eligibility

• Status: Completed
• Sex: Not specified
• Target Recruitment: 3130

Inclusion Criteria

People presenting to the Emergency Department with chest pain due to suspected but not proven Acute Myocardial Infarction (AMI) in whom a negative point-of-care marker test could potentially rule out AMI and allow discharge home.

Exclusion Criteria

1. Patients with diagnostic Electrocardiogram (ECG) changes for AMI or high-risk acute coronary syndrome (more than 1 mm ST deviation or more than 3 mm inverted T waves). These patients are at high risk of adverse outcome and require inpatient care even if marker tests are negative
2. Patients with known coronary heart disease presenting with prolonged (more than one hour) or recurrent episodes of typical cardiac-type pain. These patients have unstable angina and require inpatient care for symptom control even if marker tests are negative
3. Patients with proven or suspected serious non-coronary pathology (e.g. pulmonary embolus) that requires inpatient care even if AMI is ruled out
4. Patients with co-morbidity or social problems that require hospital admission even if AMI can be ruled out
5. Patients with an obvious non-cardiac cause (e.g. pneumothorax or muscular pain), in whom AMI can be excluded as a possible cause without resorting to further diagnostic testing
6. Patients presenting more than 12 hours after their most significant episode of pain, for whom a single troponin measurement would clearly be more appropriate than point-of-care panel testing
7. Previous participants in the RATPAC trial
8. Patients who are unable to understand the trial information due to cognitive impairment
9. Non-English speaking patients for whom translation facilities are not available

Study & Design

• Study Type: Interventional
• Study Design: Not specified