• Login
    View Item 
    •   Home
    • University Hospitals of Leicester NHS Trust
    • Renal, Respiratory and Cardiovascular
    • Cardiology
    • View Item
    •   Home
    • University Hospitals of Leicester NHS Trust
    • Renal, Respiratory and Cardiovascular
    • Cardiology
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of EMERCommunitiesPublication DateAuthorsTitlesSubjectsThis CollectionPublication DateAuthorsTitlesSubjectsProfilesView

    My Account

    LoginRegister

    Links

    About EMERPoliciesDerbyshire Community Health Services NHS Foundation TrustLeicester Partnership TrustNHS Nottingham and Nottinghamshire CCGNottinghamshire Healthcare NHS Foundation TrustNottingham University Hospitals NHS TrustSherwood Forest Hospitals NHS Foundation TrustUniversity Hospitals of Derby and Burton NHS Foundation TrustUniversity Hospitals Of Leicester NHS TrustOther Resources

    Statistics

    Most Popular ItemsStatistics by CountryMost Popular Authors

    Implementation of more sensitive cardiac troponin T assay in a state-wide health service

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Author
    Nazir, Sheraz
    Keyword
    biomarker
    health service
    myocardial infarction
    population health
    troponin
    Date
    2022
    
    Metadata
    Show full item record
    Publisher's URL
    https://www.internationaljournalofcardiology.com/article/S0167-5273(21)01782-4/fulltext
    Abstract
    Aims: Explore the impact of deploying high-sensitivity (hs) cardiac troponin T (cTnT) assay across a state-wide health service. Methods and results: Presentations to emergency departments of six tertiary hospitals between January 2008 and August 2019 were included; standard cTnT assay was superseded by hs-cTnT in June 2011 without changing the reference range (≥30 ng/L reported as elevated), despite cTnT level of 30 ng/L being equivalent to ∼44 ng/L with hs-cTnT. Clinical outcomes were captured using state-wide linked health records. Interrupted time series analyses were used adjusted for seasonality and multiple co-morbidities using propensity score matching allowing for correlation within hospitals. In total, 614,847 presentations had ≥1 troponin measurement. Clinical ordering of troponin decreased throughout the study with no increase in elevated measurements amongst those tested with hs-cTnT. Small but statistically significant changes in index myocardial infarction (MI) diagnosis (-0.36%/year, 95%CI [confidence interval]:-0.48, -0.24,p < 0.001) and invasive coronary angiography (0.12%/year,95%CI:0, 0.24,p = 0.02) were seen, with no impact on death/MI at 30 days or 3-year survival in episodes of care (EOCs) with elevated cTnT after hs-cTnT implementation. Length of stay (LOS) was shorter among those with an elevated hs-cTnT (-4.44 h/year, 95%CI:-5.27, -3.60, p < 0.001). Non-elevated cTnT EOCs demonstrated shorter total LOS and improved 3-year survival (adjusted hazard ratio:0.90, 95%CI:0.83, 0.97,p = 0.008) although death/MI at 30 days was unchanged using hs-cTnT. Conclusion: Widespread implementation of hs-cTnT without altering clinical thresholds reported to clinicians provided significantly shorter LOS without a clinically significant impact on clinical outcomes. A safer cohort with non-elevated cTnT was identified by hs-cTnT compared to the standard cTnT assay.
    Citation
    Khan, E., Lambrakis, K., Nazir, S. A., Chuang, A., Halabi, A., Tiver, K., Briffa, T., Cullen, L. A., Horsfall, M., French, J. K., Sun, B. C., & Chew, D. P. (2022). Implementation of more sensitive cardiac troponin T assay in a state-wide health service. International journal of cardiology, 347, 66–72. https://doi.org/10.1016/j.ijcard.2021.11.013
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15140
    Collections
    Cardiology

    entitlement

     
    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Quick Guide | Contact Us
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.