Could High-Sensitivity Cardiac Troponin Testing Rule Out Acute Myocardial Infarction in the Prehospital Setting?

Jamie Cooper* (Corresponding Author), James Ferguson, Lorna A Donaldson, Kim M.M. Black, Judith L Horrill, Elaine M Davidson, Neil Scott, Takeshi Fujisawa, Andrew R. Chapman, Nicholas L Mills

*Corresponding author for this work

Research output: Contribution to journalLetterpeer-review

2 Citations (Scopus)


Patients with suspected acute coronary syndrome are
often transferred by ambulance to the emergency
department. Here, strategies using a single measurement of high-sensitivity cardiac troponin (hs-cTn)
below the limit of detection (LOD) (1) or an optimized
threshold (2) can rule out myocardial infarction with
good evidence of safety and effectiveness in clinical
practice (3). Our aim was to determine if these hs-cTn
rule-out thresholds could be used to inform triage in
the prehospital setting
Original languageEnglish
Pages (from-to)2392-2394
Number of pages3
JournalJournal of the American College of Cardiology
Issue number23
Early online date29 Nov 2021
Publication statusPublished - 7 Dec 2021

Bibliographical note

This study was funded by the Digital Health & Care Institute (DHI), Scotland, and by the NHS Grampian Endowment Fund. The funders had no role in study design, data collection, interpretation, or the writing of the report. Dr Cooper was supported by a NHS Scotland Clinical Research Fellowship. Dr Chapman has received support from a Starter Grant for Clinical Lecturers by the Academy of Medical Sciences (SGL021/1075); and has received personal fees from Abbott Diagnostics. Dr Mills is supported by the British Heart Foundation through a Chair Award (CH/F/21/90010), Programme Grant (RG/20/10/34966), and a Research Excellent Award (RE/18/5/34216); has received personal fees from Abbott Diagnostics, Roche Diagnostics, Siemens Healthineers, and LumiraDx; and has received research grants awarded to the University of Edinburgh from Abbott Diagnostics and Siemens Healthineers outside the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. The authors are pleased to acknowledge the exceptional help provided by Kate Livock of NHS Grampian with delivery of this study. They also recognize the invaluable contribution of participating SAS paramedics and technicians and the support of the regional and national SAS managerial structures. They are equally thankful for the involvement of numerous medical, nursing, reception, and portering staff within the Emergency Department of Aberdeen Royal Infirmary; the advice of Amanda J. Lee, PhD, of the University of Aberdeen; the help provided by the BHF Cardiovascular Biomarker Laboratory at the University of Edinburgh; and the assistance of Gary Robinson, Chaloner Chute, and Susan Scotland from the DHI. Clinical Trial: Research Registry (UIN 2671).


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