Clin Exp Emerg Med.
2022 Jun;9(2):140-145. 10.15441/ceem.21.154.
Finding acute coronary syndrome with serial troponin testing for rapid assessment of cardiac ischemic symptoms (FAST-TRAC): a study protocol
- Peacock WF
1 - Maisel AS2
- Mueller C3
- Anker SD4
- Apple FS5
- Christenson RH6
- Collinson P7
- Daniels LB2
- Diercks DB8
- Somma SD9
- Filippatos G10
- Headden G11
- Hiestand B12
- Hollander JE13
- Kaski JC7
- Kosowsky JM14
- Nagurney JT15
- Nowak RM16
- Schreiber D17
- Vilke GM2
- Wayne MA18
- Than M19
- Affiliations
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- 1Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
- 2Department of Cardiology, University of California, La Jolla, CA, USA
- 3Department of Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Basel, Switzerland
- 4Department of Cardiology, Charité Campus Virchow-Klinikum, Berlin, Germany
- 5Department of Lab Medicine, Hennepin Healthcare/Hennepin County Medical Center & University of Minnesota School of Medicine, Minneapolis, MN, USA
- 6Department of Lab Medicine, University of Maryland Medical Center, Baltimore, MD, USA
- 7Department of Lab Medicine, St. George’s University of London, London, UK
- 8Department of Emergency Medicine, University of Texas Southwestern, Dallas, TX, USA
- 9Department of Emergency Medicine, Sapienza University, Rome, Italy
- 10Department of Critical Care, University Hospital Attikon, Athens, Greece
- 11Department of Emergency Medicine, Medical University of South Carolina, Charleston, SC, USA
- 12Department of Emergency Medicine, Wake Forest University, Winston-Salem, NC, USA
- 13Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA, USA
- 14Department of Emergency Medicine, Brigham & Women’s Hospital, Boston, MA, USA
- 15Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
- 16Department of Emergency Medicine, Henry Ford Health System, Detroit, MI, USA
- 17Department of Emergency Medicine, Stanford University School of Medicine Palo Alto, CA, USA
- 18Department of Emergency Medicine, PeaceHealth St. Joseph Medical Center, Bellingham, WA, USA
- 19Department of Emergency Medicine, Christchurch Hospital, Christchurch, New Zealand
- KMID: 2531349
- DOI: http://doi.org/10.15441/ceem.21.154
Abstract
Objective
To determine the utility of a highly sensitive troponin assay when utilized in the emergency department.
Methods
The FAST-TRAC study prospectively enrolled >1,500 emergency department patients with suspected acute coronary syndrome within 6 hours of symptom onset and 2 hours of emergency department presentation. It has several unique features that are not found in the majority of studies evaluating troponin. These include a very early presenting population in whom prospective data collection of risk score parameters and the physician’s clinical impression of the probability of acute coronary syndrome before any troponin data were available. Furthermore, two gold standard diagnostic definitions were determined by a pair of cardiologists reviewing two separate data sets; one that included all local troponin testing results and a second that excluded troponin testing so that diagnosis was based solely on clinical grounds. By this method, a statistically valid head-to-head comparison of contemporary and high sensitivity troponin testing is obtainable. Finally, because of a significant delay in sample processing, a unique ability to define the molecular stability of various troponin assays is possible. Trial registration ClinicalTrials.gov Identifier NCT00880802
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