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
Contains fulltext : 218671.pdf (Publisher’s version ) (Open Access) 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 evalu...
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Online Access: | https://hdl.handle.net/2066/218671 https://repository.ubn.ru.nl//bitstream/handle/2066/218671/218671.pdf https://doi.org/10.1136/bmjopen-2019-034403 |
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ftunivnijmegen:oai:repository.ubn.ru.nl:2066/218671 2023-09-05T13:17:54+02:00 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 Aarts, G.W.A. Camaro, C. Geuns, R.J.M. van Cramer, E. Kimmenade, R.R.J. van Damman, P. Grunsven, P.M. van Adang, E.M. Giesen, P.H. Rutten, M.H. Ouwendijk, O. Gomes, M.E.R. Royen, N. van 2020 https://hdl.handle.net/2066/218671 https://repository.ubn.ru.nl//bitstream/handle/2066/218671/218671.pdf https://doi.org/10.1136/bmjopen-2019-034403 unknown https://repository.ubn.ru.nl//bitstream/handle/2066/218671/218671.pdf https://hdl.handle.net/2066/218671 doi:10.1136/bmjopen-2019-034403 BMJ Open, 10, 2 Radboudumc 16: Vascular damage RIHS: Radboud Institute for Health Sciences Radboudumc 16: Vascular damage RIMLS: Radboud Institute for Molecular Life Sciences Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health Sciences Article / Letter to editor 2020 ftunivnijmegen https://doi.org/10.1136/bmjopen-2019-034403 2023-08-23T22:08:33Z Contains fulltext : 218671.pdf (Publisher’s version ) (Open Access) 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). Article in Journal/Newspaper artica Radboud University: DSpace BMJ Open 10 2 e034403 |
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Radboud University: DSpace |
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ftunivnijmegen |
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unknown |
topic |
Radboudumc 16: Vascular damage RIHS: Radboud Institute for Health Sciences Radboudumc 16: Vascular damage RIMLS: Radboud Institute for Molecular Life Sciences Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health Sciences |
spellingShingle |
Radboudumc 16: Vascular damage RIHS: Radboud Institute for Health Sciences Radboudumc 16: Vascular damage RIMLS: Radboud Institute for Molecular Life Sciences Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health Sciences Aarts, G.W.A. Camaro, C. Geuns, R.J.M. van Cramer, E. Kimmenade, R.R.J. van Damman, P. Grunsven, P.M. van Adang, E.M. Giesen, P.H. Rutten, M.H. Ouwendijk, O. Gomes, M.E.R. Royen, N. van 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 |
topic_facet |
Radboudumc 16: Vascular damage RIHS: Radboud Institute for Health Sciences Radboudumc 16: Vascular damage RIMLS: Radboud Institute for Molecular Life Sciences Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health Sciences |
description |
Contains fulltext : 218671.pdf (Publisher’s version ) (Open Access) 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). |
format |
Article in Journal/Newspaper |
author |
Aarts, G.W.A. Camaro, C. Geuns, R.J.M. van Cramer, E. Kimmenade, R.R.J. van Damman, P. Grunsven, P.M. van Adang, E.M. Giesen, P.H. Rutten, M.H. Ouwendijk, O. Gomes, M.E.R. Royen, N. van |
author_facet |
Aarts, G.W.A. Camaro, C. Geuns, R.J.M. van Cramer, E. Kimmenade, R.R.J. van Damman, P. Grunsven, P.M. van Adang, E.M. Giesen, P.H. Rutten, M.H. Ouwendijk, O. Gomes, M.E.R. Royen, N. van |
author_sort |
Aarts, G.W.A. |
title |
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 |
title_short |
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 |
title_full |
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 |
title_fullStr |
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 |
title_full_unstemmed |
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 |
title_sort |
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 |
publishDate |
2020 |
url |
https://hdl.handle.net/2066/218671 https://repository.ubn.ru.nl//bitstream/handle/2066/218671/218671.pdf https://doi.org/10.1136/bmjopen-2019-034403 |
genre |
artica |
genre_facet |
artica |
op_source |
BMJ Open, 10, 2 |
op_relation |
https://repository.ubn.ru.nl//bitstream/handle/2066/218671/218671.pdf https://hdl.handle.net/2066/218671 doi:10.1136/bmjopen-2019-034403 |
op_doi |
https://doi.org/10.1136/bmjopen-2019-034403 |
container_title |
BMJ Open |
container_volume |
10 |
container_issue |
2 |
container_start_page |
e034403 |
_version_ |
1776198948125409280 |