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  • Implementation of rapid rule out of myocardial infarction using high-sensitivity troponin: cross-sectional survey of English hospitals

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Implementation of rapid rule out of myocardial infarction using high-sensitivity troponin: cross-sectional survey of English hospitals
  1. Shabnam Thapa,
  2. Ruth Wong,
  3. Steve Goodacre
  1. School of Health and Related Research, University of Sheffield, Sheffield, UK
  1. Correspondence to Professor Steve Goodacre, School of Health and Related Research, University of Sheffield, Sheffield, UK; s.goodacre{at}sheffield.ac.uk

Abstract

Objectives Recent guidance recommended use of high-sensitivity troponin for rapid rule out of myocardial infarction (MI) in the English health service. We aimed to determine the extent of implementation of this guidance across English hospitals.

Methods This study conducted a cross-sectional questionnaire survey of 131 English acute hospitals with over 10 000 admissions per year.

Results We received 125/131 responses (95%), with 110/125 (88%) reporting use of a high-sensitivity troponin assay and responses showing progressive implementation over the last 10 years. High-sensitivity troponin was reported to be used for rapid rule out of MI in 92/110 Trusts (84%). Review of guidelines received from 95/110 Trusts identified that 71/95 (75%) provided guidance for rapid MI rule out with high-sensitivity troponin: 57 recommended testing at 0 and 3 hours, 4 recommended testing at 0 and 2 hours, and 9 recommended testing at 0 and 1 hour, and timing was unclear at one Trust.

Conclusions English acute hospital Trusts report widespread implementation of high-sensitivity troponin for rapid rule out of MI, with most recommending testing at 0 and 3 hours.

  • troponin
  • myocardial infarction
  • guidelines

https://doi.org/10.1136/emermed-2019-209100

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    Footnotes

    • Contributors SG conceived the study. SG and RW designed the study. ST collected and analysed the data. ST wrote the first draft. All authors contributed to redrafting and approved the final draft.

    • Funding The University of Sheffield funded the study.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on reasonable request.