[Articles] High-sensitivity troponin in the evaluation of patients with suspected acute coronary syndrome: a stepped-wedge, cluster-randomised controlled trial
September 23, 2018
- The Lancet 392, 10151 (2018)
Author: Anoop S V Shah, Atul Anand, Fiona E Strachan, Amy V Ferry, Kuan Ken Lee, Andrew R Chapman, Dennis Sandeman, Catherine L Stables, Philip D Adamson, Jack P M Andrews, Mohamed S Anwar, John Hung, Alistair J Moss, Rachel O'Brien, Colin Berry, Iain Findlay, Simon Walker, Anne Cruickshank, Alan Reid, Alasdair Gray, Paul O Collinson, Fred S Apple, David A McAllister, Donogh Maguire, Keith A A Fox, David E Newby, Christopher Tuck, Ronald Harkess, Richard A Parker, Catriona Keerie, Christopher J Weir, Nicholas L Mills, High-STEACS Investigators
Use of a high-sensitivity assay prompted reclassification of 1771 (17%) of 10 360 patients with myocardial injury or infarction, but was not associated with a lower subsequent incidence of myocardial infarction or cardiovascular death at 1 year. Our findings question whether the diagnostic threshold for myocardial infarction should be based on the 99th centile derived from a normal reference population.