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. 2017 May 18:8:85-90.
doi: 10.2147/POR.S130807. eCollection 2017.

Design and rationale of the high-sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial

Benton R Hunter  1 , Sean P Collins  2 , Gregory J Fermann  3 , Phillip D Levy  4 , Changyu Shen  5 , Syed Imran Ayaz  4 , Mette L Cole  1 , Karen F Miller  2 , Adam A Soliman  3 , Peter S Pang  1   6
Affiliations

Design and rationale of the high-sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial

Benton R Hunter et al. Pragmat Obs Res. .

Abstract

Background: Acute heart failure (AHF) is a common presentation in the Emergency Department (ED), and most patients are admitted to the hospital. Identification of patients with AHF who have a low risk of adverse events and are suitable for discharge from the ED is difficult, and an objective tool would be useful.

Methods: The highly sensitive Troponin T Rules Out Acute Cardiac Insufficiency Trial (TACIT) will enroll ED patients being treated for AHF. Patients will undergo standard ED evaluation and treatment. High-sensitivity troponin T (hsTnT) will be drawn at the time of enrollment and 3 hours after the initial draw. The initial hsTnT draw will be no more than 3 hours after initiation of therapy for AHF (vasodilator, loop diuretic, noninvasive ventilation). Treating clinicians will be blinded to hsTnT results. We will assess whether hsTnT, as a single measurement or in series, can accurately predict patients at low risk of short-term adverse events.

Conclusion: TACIT will explore the value of hsTnT measurements in isolation, or in combination with other markers of disease severity, for the identification of ED patients with AHF who are at low risk of short-term adverse events.

Keywords: heart failure; high-sensitivity troponin; hospitalization.

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Conflict of interest statement

Disclosure Mette Cole receives research support from Novartis and Roche Diagnostics. Karen Miller receives research support from NIH, PCORI, Novartis, Roche, and Trinity Biotech. Peter S Pang is or has been in the last 1 year a consultant for BMS, Janssen, Medtronic, Novartis, Trevena, scPharmaceuticals, Roche Diagnostics, and Relypsa. Sean P Collins is a consultant for Trevena, Cardiorentis, Novartis, Siemens, and Cardioxyl. Phillip Levy is a consultant for Janssen, Medtronic, The Medicines Company, Novartis, Trevena, Cardiorentis, Siemens, Roche Diagnostics, ZS Pharma, and Apex Innovations. Gregory J Fermann is a consultant for Pfizer and Janssen. The other authors report no conflicts of interest in this work.

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