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Tytuł pozycji:

Acute rule-out of non-ST-segment elevation acute coronary syndrome in the (pre)hospital setting by HEART score assessment and a single point-of-care troponin: rationale and design of the ARTICA randomised trial.

Tytuł :
Acute rule-out of non-ST-segment elevation acute coronary syndrome in the (pre)hospital setting by HEART score assessment and a single point-of-care troponin: rationale and design of the ARTICA randomised trial.
Autorzy :
Aarts GWA; Cardiology, Radboudumc, Nijmegen, The Netherlands.
Camaro C; Cardiology, Radboudumc, Nijmegen, The Netherlands.
van Geuns RJ; Cardiology, Radboudumc, Nijmegen, The Netherlands.
Cramer E; Cardiology, Radboudumc, Nijmegen, The Netherlands.
van Kimmenade RRJ; Cardiology, Radboudumc, Nijmegen, The Netherlands.
Damman P; Cardiology, Radboudumc, Nijmegen, The Netherlands.
van Grunsven PM; Ambulancezorg, Veiligheidsregio Gelderland-Zuid, Nijmegen, The Netherlands.
Adang E; Health Evidence, Radboudumc, Nijmegen, The Netherlands.
Giesen P; Scientific Institute for Quality of Healthcare, Radboudumc, Nijmegen, The Netherlands.
Rutten M; Scientific Institute for Quality of Healthcare, Radboudumc, Nijmegen, The Netherlands.
Ouwendijk O; Huisartsenpost Nijmegen, Nijmegen, The Netherlands.
Gomes MER; Cardiology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
van Royen N; Cardiology, Radboudumc, Nijmegen, The Netherlands .
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Źródło :
BMJ open [BMJ Open] 2020 Feb 17; Vol. 10 (2), pp. e034403. Date of Electronic Publication: 2020 Feb 17.
Typ publikacji :
Clinical Trial Protocol; Journal Article; Research Support, Non-U.S. Gov't
Język :
English
Imprint Name(s) :
Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
MeSH Terms :
Acute Coronary Syndrome*/diagnosis
Point-of-Care Systems*
Troponin*
Biomarkers ; Chest Pain ; Electrocardiography ; Hospitals ; Humans ; Netherlands ; Prospective Studies ; Randomized Controlled Trials as Topic ; Troponin T
References :
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Arch Acad Emerg Med. 2019 Aug 28;7(1):e52. (PMID: 31602435)
Contributed Indexing :
Keywords: acute coronary syndrome*; ambulance*; cost-effectiveness*; modified HEART score*; point-of-care troponin*; pre-hospital*
Molecular Sequence :
NTR NL7148
Substance Nomenclature :
0 (Biomarkers)
0 (Troponin)
0 (Troponin T)
Entry Date(s) :
Date Created: 20200220 Date Completed: 20210326 Latest Revision: 20210326
Update Code :
20210327
PubMed Central ID :
PMC7044902
DOI :
10.1136/bmjopen-2019-034403
PMID :
32071186
Czasopismo naukowe
Introduction: Because of the lack of prehospital protocols to rule out a non-ST-segment elevation acute coronary syndrome (NSTE-ACS), patients with chest pain are often transferred to the emergency department (ED) for thorough evaluation. However, in low-risk patients, an ACS is rarely found, resulting in unnecessary healthcare consumption. Using the HEART (History, ECG, Age, Risk factors and Troponin) score, low-risk patients are easily identified. When a point-of-care (POC) troponin measurement is included in the HEART score, an ACS can adequately be ruled out in low-risk patients in the prehospital setting. However, it remains unclear whether a prehospital rule-out strategy using the HEART score and a POC troponin measurement in patients with suspected NSTE-ACS is cost-effective.
Methods and Analysis: The ARTICA trial is a randomised trial in which the primary objective is to investigate the cost-effectiveness after 30 days of an early rule-out strategy for low-risk patients suspected of a NSTE-ACS, using a modified HEART score including a POC troponin T measurement. Patients are included by ambulance paramedics and 1:1 randomised for (1) presentation at the ED (control group) or (2) POC troponin T measurement (intervention group) and transfer of the care to the general practitioner in case of a low troponin T value. In total, 866 patients will be included. Follow-up will be performed after 30 days, 6 months and 12 months.
Ethics and Dissemination: This trial has been accepted by the Medical Research Ethics Committee region Arnhem-Nijmegen. The results of this trial will be disseminated in one main paper and in additional papers with subgroup analyses.
Trial Registration Number: Netherlands Trial Register (NL7148).
(© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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