Study of High-Sensitivity Troponin I Testing Alongside Standard Emergency Care in Ambulance Services for Adults With Chest Pain or Suspected Heart Attack

What this Trial Is About

Researchers are evaluating the use of a high-sensitivity Troponin I blood test in emergency medical services EMS to improve early detection of heart attacks in patients with chest pain or suspected myocardial infarction. This randomized controlled trial compares the addition of this quick test to standard guideline-based care during ambulance transport in Stockholm, Sweden. The study aims to see if early biomarker testing can speed up diagnosis and treatment, potentially improving patient outcomes. Participants are randomly assigned in a 21 ratio to receive either standard EMS care plus the point-of-care Troponin I test using the Siemens Atellica4 VTLi system or standard care alone. The Troponin test result is available in real-time to EMS providers and communicated to the hospital during handover. The study includes safety monitoring with an interim analysis after 150 patients and plans to enroll about 1,419 adults. During the study, participants will receive emergency care according to their assigned group. Researchers will measure the time from first medical contact to vascular access during PCI, as well as other time intervals such as to ECG and emergency department admission. They will also track hospital length of stay, major cardiac events, intervention frequency, and diagnostic accuracy of the Troponin test. The study lasts through the hospital stay and includes follow-up at 30 days to assess outcomes and safety.

High-Sensitivity Troponin I in Addition to Guideline-Based Care in EMS