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Design and rationale of the high-sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial

Authors Hunter BR, Collins SP, Fermann GJ, Levy PD, Shen C, Ayaz SI, Cole ML, Miller KF, Soliman AA, Pang PS

Received 21 December 2016

Accepted for publication 13 March 2017

Published 18 May 2017 Volume 2017:8 Pages 85—90

DOI https://doi.org/10.2147/POR.S130807

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 3

Editor who approved publication: Professor David Price


Benton R Hunter,1 Sean P Collins,2 Gregory J Fermann,3 Phillip D Levy,4 Changyu Shen,5 Syed Imran Ayaz,4 Mette L Cole,1 Karen F Miller,2 Adam A Soliman,3 Peter S Pang1,6

1Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 2Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, 3Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH, 4Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, MI, 5Department of Biostatistics, Indiana University School of Medicine, 6Department of Indianapolis EMS, The Regenstrief Institute, IN, USA

Background: Acute heart failure (AHF) is a common presentation in the Emergency Department (ED), and most patients are admitted to the hospital. Identification of patients with AHF who have a low risk of adverse events and are suitable for discharge from the ED is difficult, and an objective tool would be useful.
Methods: The highly sensitive Troponin T Rules Out Acute Cardiac Insufficiency Trial (TACIT) will enroll ED patients being treated for AHF. Patients will undergo standard ED evaluation and treatment. High-sensitivity troponin T (hsTnT) will be drawn at the time of enrollment and 3 hours after the initial draw. The initial hsTnT draw will be no more than 3 hours after initiation of therapy for AHF (vasodilator, loop diuretic, noninvasive ventilation). Treating clinicians will be blinded to hsTnT results. We will assess whether hsTnT, as a single measurement or in series, can accurately predict patients at low risk of short-term adverse events.
Conclusion:
TACIT will explore the value of hsTnT measurements in isolation, or in combination with other markers of disease severity, for the identification of ED patients with AHF who are at low risk of short-term adverse events.

Keywords:
heart failure, high-sensitivity troponin, hospitalization

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