Implementing the 6th Generation Cardiac Troponin T
Implementing the 6th Generation Cardiac Troponin T: A Stepped Wedged Cluster-randomized Trial
This study will test how a new blood test for troponin T can be introduced into routine hospital care in Denmark and Norway. The study will look at whether the new test helps doctors assess and treat patients with possible heart problems more effectively and safely.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Background Cardiac troponin (cTn) is the key biomarker for diagnosing myocardial infarction (MI). There are two cardiac specific isoforms of cTn, cTnT and cTnI, considered equal in contemporary guidelines. About half of hospitals in Denmark and two thirds of Norwegian providing acute cardiovascular care use cTnT from Roche Diagnostics in routine practice. An improved version of this assay has recently been developed, named the 6th generation cTnT. This novel assay expected to be implemented worldwide within the next years, but there is still limited data comparing it with the previous generation of cTnT. We aim to implement and test the use of the new 6th generation cTnT assay in Danish-Norwegian collaborative, stepped-wedge trial.
Methods This will be a stepped-wedged cluster-randomized implementation study investigating the medical and practical real-life consequences of switching from the 5th to the 6th generation cTnT assay in routine use. All hospitals using cTnT in either Denmark or Norway will be invited to participate in the study. Centers will be randomized to an implementation date. The hospital should switch assay within 1-15 days after the applicable deadline. Following admission, patients will be followed through national registries.
Assay specifics The 6th generation cTnT assay is expected to have a limit of quantification at 1.5 ng/L and an analyti-cal variation of 3% at the 99th upper reference limit. All sites will use the reference values estimated in the assay insert.
Timeline There will be 7 centers in Denmark and 4 centers in Norway in the study. Data collection will begin on the 1st of August 2026 with the first centers expected to switch on the 1st of October 2026. This will mean that the final center will switch on the 1st of August 2027, and the primary results will be available by the end of March 2028. Each laboratory will receive a plan for local analytical verification of the assay.
Collaboration The study is designed and performed as a collaborative effort between Danish and Norwegian re-searchers and led by Kristin Aakre, Rasmus Bo Hasselbalch, Torbjørn Omland and Kasper Iversen. All centers will be invited to participate and contributors fulfilling Vancouver criteria will be invited as authors of any publications. This implementation study will be performed in collaboration with the national societies of clinical biochemistry.
Ethics The project has been presented to the Danish regional ethics committee and is expected to receive a waiver for patient consent in this study. A similar ethical waiver has been given in Norway. The data will follow GDPR guidelines regarding data protection.
Power calculations In a stepped wedge design the period between successive interventions (i.e. stops) is the main design parameter. The study is designed as a primary superiority trial. Given 11 centers and an ex-pected event rate of about 4% and each center including between 200 and 800 patients a month, the study would have above 90% power to show an absolute risk difference of 0.8%. This calcula-tion was performed in collaboration with Professor Theis Lange.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Rasmus B Hasselbalch, MD, PhD
- Telefonnummer: +45 38683868
- E-mail: rasmus.bo.hasselbalch@regionh.dk
Undersøgelse Kontakt Backup
- Navn: Kristin Aakre, MD, PhD
- E-mail: kristin.moberg.aakre@helse-bergen.no
Studiesteder
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Herlev, Danmark, 2730
- Ikke rekrutterer endnu
- Copenhagen University Hospital - Herlev and Gentofte Hospital
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Kontakt:
- Kasper Iversen, Md, Dmsc
- Telefonnummer: +45 38683868
- E-mail: Kasper.karmark.iversen@regionh.dk
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Horsens, Danmark, 8700
- Ikke rekrutterer endnu
- Regionshospitalet Horsens
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Kontakt:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: +45 35453545
- E-mail: rasmus.bo.hasselbalch@regionh.dk
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Kolding, Danmark, 6000
- Ikke rekrutterer endnu
- Sygehus Lillebælt
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Kontakt:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: 35453545
- E-mail: rasmus.bo.hasselbalch@regionh.dk
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København NV, Danmark, 2400
- Ikke rekrutterer endnu
- Copenhagen University Hospital - Bispebjerg
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Kontakt:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: +45 35453545
- E-mail: rasmus.bo.hasselbalch@regionh.dk
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København Ø, Danmark, 2100
- Ikke rekrutterer endnu
- Copenhagen University Hospital - Rigshospitalet
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Kontakt:
- Rasmus Hasselbalch
- Telefonnummer: +45 34453545
- E-mail: rasmus.bo.hasselbalch@regionh.dk
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Odense, Danmark, 5000
- Rekruttering
- Odense Universitetshospital
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Kontakt:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: +45 35453545
- E-mail: rasmus.bo.hasselbalch@regionh.dk
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Svendborg, Danmark, 5700
- Ikke rekrutterer endnu
- Odense Universitetshospital Svendborg Sygehus
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Kontakt:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: +45 35453545
- E-mail: rasmus.bo.hasselbalch@regionh.dk
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Sønderborg, Danmark, 6400
- Ikke rekrutterer endnu
- Sygehus Sønderjylland
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Kontakt:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: +45 35453545
- E-mail: rasmus.bo.hasselbalch@regionh.dk
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Bergen, Norge, 5009
- Ikke rekrutterer endnu
- Haraldsplass Diakonale sykehus
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Haukeland, Norge, 5009
- Ikke rekrutterer endnu
- Haukeland Universitetshospital
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Hønefoss, Norge, 3511
- Ikke rekrutterer endnu
- Vestre Viken HF
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Kristiansand, Norge, 4604
- Ikke rekrutterer endnu
- Sørlandet Sykehus HF
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Lørenskog, Norge, 1478
- Ikke rekrutterer endnu
- Akershus Universitetssykehus HF
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Nydalen, Norge, 4950
- Ikke rekrutterer endnu
- Oslo Universitetssykehus HF
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Oslo, Norge, 0370
- Ikke rekrutterer endnu
- Diakonhjemmet Sykehus
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Oslo, Norge, 0456
- Ikke rekrutterer endnu
- Lovisenberg Sykehus
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Stavanger, Norge, 4011
- Ikke rekrutterer endnu
- Helse Stavanger HF - Stavanger universitetssjukehus
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Tromsø, Norge, 9019
- Rekruttering
- Universitetssykehuset Nord-Norge HF
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Trondheim, Norge, 7030
- Ikke rekrutterer endnu
- St. Olavs Hospital HF
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Tønsberg, Norge, 3103
- Ikke rekrutterer endnu
- Sykehuset i Vestfold HF
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Ålesund, Norge, 6017
- Ikke rekrutterer endnu
- Ålesund sjukehus
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Ålesund, Norge, 6026
- Rekruttering
- Helse Møre og Romsdal HF
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Kontakt:
- Kristin Aakre, Md, PhD
- Telefonnummer: 55975000
- E-mail: kristin.moberg.aakre@helse-bergen.no
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Admitted at any of the participating hospitals
- At least one measurement of cardiac troponin T as a part of routine care in the ED
Exclusion Criteria:
- Readmission within the study followup
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Diagnostisk
- Tildeling: Randomiseret
- Interventionel model: Sekventiel tildeling
- Maskning: Enkelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: 5th generation cardiac troponin T arm
Treatment is based on the use of the 5th generation troponin T assay |
Regular use of the 5th generation troponin T assay |
|
Eksperimentel: 6th generation cardiac troponin T arm
Treatment is based on the use of the new 6th generation troponin T assay |
The change will be in a stepped-wedge cluster randomised design |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Composite endpoint of death from any cause and MI, or revascularization within 6 months after admission (PCI and CABG).
Tidsramme: 6 months
|
This will exclude events during the index admission |
6 months
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
The incidence of fatal and non-fatal MI (I21, I22)
Tidsramme: At the time of hospital discharge (Day 0)
|
All events during admission |
At the time of hospital discharge (Day 0)
|
|
Unstable angina pectoris (I20.0)
Tidsramme: At the time of hospital discharge (Day 0)
|
Unstable angina diagnosed during admission |
At the time of hospital discharge (Day 0)
|
|
Invasive coronary angiography
Tidsramme: Up to 30 days following discharge
|
Use of invasive coronary angiography during admission, or planned under index admission |
Up to 30 days following discharge
|
|
Coronary CT angiography
Tidsramme: Up to 30 days following discharge
|
Use of coronary CT angiography during admission or planned at index admission |
Up to 30 days following discharge
|
|
The length of stay
Tidsramme: At the time of hospital discharge (Day 0)
|
The length of stay during index admission |
At the time of hospital discharge (Day 0)
|
|
Readmissions within 30 days
Tidsramme: Within 30 days of index admission
|
The rate of readmission following index admission within 30 days for any cardiovascular cause |
Within 30 days of index admission
|
Andre resultatmål
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Percentage discharged from the hospital within 6 hours
Tidsramme: At the time of hospital discharge (Day 0)
|
Percentage discharged from the hospital within 6 hours (if data can be made available) |
At the time of hospital discharge (Day 0)
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Kristin Aakre, MD, PhD, Haukeland University Hospital
- Ledende efterforsker: Kasper Iversen, MD, Dmsc, Copenhagen University Hospital - Herlev and Gentofte Hospital
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- F-26025642
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Due to restrictions within Danish and Norwegian law for registry data
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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