SuperTROPO (Better Diagnostics of Myocardial Infarction With a Test for Special Forms of Troponin)

Turku University Hospital3,000 enrolled

Overview

The aim of this study is to investigate whether measurement of the long forms of cTnT with the novel SuperTROPO assay would improve the diagnosis of myocardial infarction in patients in the emergency department. The main goals are: 1. To assess whether measuring long forms of cTnT with the novel SuperTROPO assay and determining the ratio of long cTnT and standard high-sensitivity cTnT could separate patients with type 1 NSTEMI patients from patients with other causes of minor (\> 14ng/L) cTnT elevation in a single admission blood sample in unselected emergency department patients with clinical indication for troponin measurement. 2. To compare the level of long cTnT and the ratio of long cTnT and standard cTnT in patients with type 1 MI and various clinical patient groups admitted to emergency department with elevated standard cTnT, e.g. patients with atrial fibrillation, heart failure or renal impairment. 3. To evaluate optimal cut-off values for long cTnT and its ratio to standard cTnT in the exclusion and diagnosis of MI in a clinical setting with elevated (\>14ng/L) cTnT. 4. To evaluate how time from symptom onset and peak symptom to blood sampling, as well as comorbidities and patients' age impact the discriminative capacity of long cTnT and cTnT ratio between patients with and without type 1 MI. 5. To investigate whether information on long cTnT and its ratio to standard cTnT can be used to cut down unnecessary coronary angiographies and hospital admissions The long forms of cTnT are measured from the residual blood samples routinely collected from patients with suspected myocardial infarction.

Study Type

OBSERVATIONAL

Enrollment

3,000

Conditions

Myocardial Infarction Myocardial Ischemia

Interventions

Eligibility

Sex: ALLMin age: 19 YearsMax age: 110 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patient has arrived at the emergency department and high-sensitivity cTnT test (P-TnT) has been ordered as part of the routine "cardiac package" of laboratory tests upon arrival * Result of \>14 ng/L of the P-TnT test included in the "cardiac package" * Age \> 18 * The patient or his/her legal representative has given written informed consent for participation in the study Exclusion Criteria: * unable to give informed consent * legally incompetent individuals * pregnancy * previously participated in this study

Outcomes

Primary Outcomes

Myocardial infarction type 1

In brief, type 1 MI will be diagnosed when there is evidence of myocardial necrosis along with a clinical setting consistent with acute myocardial ischemia, as well as a coronary plaque rupture or erosion and superimposed thrombosis. The presence of the final diagnosis of type 1 MI by the treating clinician will be reviewed from patient records of the index hospitalization. Furthermore, patients with type 2 MI, will be identified and analyzed separately. The proportion of patients with type MI will be calculated and troponin values will be compared with patients with and without MI. .

Time frame: During the index hospitalization, that is, the hospitalization after the drawn blood samples at the emergency department. Up to 12 weeks.