Patients under evaluation for acute coronary syndrome (ACS) without clear ischemia signs in an electrocardiogram find no benefit in a 0/1-hour high-sensitivity troponin T (ultra-fast) protocol compared with the conventional 0/3-hour protocol.
These data come from the RAPID-TnT trial presented during the scientific sessions at the American College of Cardiology (ACC) 2021 Congress, simultaneously published in Circulation.
RAPID-TnT enrolled 3378 patients with suspected ACS and randomized them to a fast-testing protocol (0/1 hour) with a 5th generation high-sensitivity troponin T (detection limit: 4 ng/L) vs. the standard protocol (0/3 hour; detection limit: 29 ng/l).
The hypothesis of the study was that having this sensitive information faster could aid decision-making and ultimately impact events, something that ultimately did not happen.
The ultra-fast protocol was associated with fewer functional testing and more coronary angiography and revascularization, but it did not translate into differences in mortality or infarction at one year compared with the conventional protocol (5.0% vs. 3.8%; hazard ratio: 1.32; 95% confidence interval: 0.95-1.83).
Read also: ACC 2021 | Relive Renal Denervation with RADIANCE-HTN TRIO.
Esta información llena un vacío que existía en términos de velocidad de diagnóstico. Se especulaba que cuanto más rápido tuviéramos los datos mejor administraríamos los estudios complementarios y esto finalmente impactaría en eventos clínicos.
Original Title: Late outcomes of the RAPID-TnT RCT: a 0/1-hour high-sensitivity troponin T protocol in suspected ACS.
Reference: Lambrakis K et al. Presentado en el congreso de la ACC 2021 y publicado simultáneamente en Circulation. 2021;Epub ahead of print. DOI: 10.1161/CIRCULATIONAHA.121.055009.
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