Trial of switching high-sensitivity cardiac troponin assays in suspected acute coronary syndrome: an interrupted time series analysis (TWITCH-ED study)

When the heart is damaged troponin is being released in the bloodstream. High-sensitivity troponin tests measure the troponin level in the blood and are the preferred choice for the diagnosis of a heart attack. In clinical practice either a high-sensitivity troponin I or T test is being used. They are both recommended in current guidelines, but limited data is available about the agreement between the diagnostic cut offs of high-sensitivity troponin I and T.

NHS Lothian hospitals have changed from a high-sensitivity troponin I to a T test. As part of this process, it is standard laboratory practice for NHS Lothian to verify the performance of the new test. Therefore, we will evaluate in patients who present to the Emergency Department with a suspicion of a heart attack whether more patients are going to be hospitalised and the impact on cardiac investigations, care and clinical outcomes.