Unrestricted high-sensitivity cardiac troponin T reporting in emergency departments led to a 6.2 percentage point increase in discharge rates, representing a 16% relative increase, and shorter hospital stays, without an increase in myocardial infarction diagnoses or invasive procedures, according to a recent study.
The cohort study examined the impact of high-sensitivity cardiac troponin T (hs-cTnT) reporting to the lowest quantifiable limit compared with conventional troponin reporting on clinical outcomes and health care resource utilization. The study included 40,921 patients aged 18 years or older who presented to South Australian emergency departments (EDs) between February 2020 and February 2021.
Key findings, published in JAMA Network Open, indicated that unrestricted hs-cTnT reporting was associated with improved resource utilization without an increase in myocardial infarction (MI) diagnoses or invasive procedures. The hs-cTnT group (n=20,206; median age, 62 years) demonstrated a higher ED discharge rate compared with the conventional troponin group (45.2% vs 39.0%; P < .001) and a shorter median hospital length of stay (7.68 hours vs 7.92 hours; P < .001). There was no significant difference in MI diagnoses (3.4% vs 3.5%; P = .76), coronary angiography (4.6% vs 4.4%; P = .58), or revascularization procedures (percutaneous coronary intervention: 2.1% vs 2.3%; P = .12; coronary artery bypass graft: 0.5% vs 0.4%; P = .34).
At 12 months, the composite outcome of all-cause mortality, MI, and myocardial injury was similar between groups (adjusted hazard ratio [HR], 0.95; 95% confidence interval [CI], 0.90-1.01; P = .09).
The study findings indicate that unrestricted hs-cTnT reporting in EDs was associated with higher discharge rates and shorter hospital stays, with no significant increase in MI diagnoses or the need for invasive coronary procedures, though there was a higher risk of type 2 MI or myocardial injury at 12 months (HR 1.31, 95% CI, 1.08-1.60; P = .007).
Full disclosures can be found in the published study.