Modest changes in practice for high-sensitivity TnT reporting

(HealthDay)—For patients presenting to the emergency department with chest pain, high-sensitivity troponin T (hs-TnT) reporting is associated with modest changes in practice, according to a study published online Aug. 9 in Circulation: Cardiovascular Quality and Outcomes.

Derek P. Chew, M.B.B.S., M.P.H., from Flinders University in Adelaide, Australia, and colleagues examined the impact of hs-TnT reporting on care and outcome among patients presenting to emergency departments with chest pain. A total of 1,937 patients without ST-segment elevation were enrolled and randomized to hs-TnT reporting (hs-report) or standard reporting (std-report).

The researchers found that 75.7 percent of patients had maximal troponin <30 ng/L within 24 hours. The admission rate was not altered with randomization to hs-report format (hs-report: 57.7 percent versus std-report: 58.0 percent; P = 0.069). There was no between-group difference in angiography (hs-report: 11.9 percent versus std-report: 10.9 percent; P = 0.479). There was no reduction in 12-month death or new-recurrent acute coronary syndrome in the overall population with hs-report (hs-report: 9.7 percent versus std-report: 7.2 percent; P = 0.362). There was a modest reduction in the primary end point among those with troponin levels <30 ng/mL (hs-report: 2.6 percent versus std-report: 4.4 percent; P = 0.050).

"High-sensitivity troponin reporting alone is associated with only modest changes in practice," the authors write. "Clinical effectiveness in the adoption of high-sensitivity troponin may require close coupling with protocols that guide interpretation and care."

Several authors disclosed financial ties to the pharmaceutical industry.