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Implementing the 6th Generation Cardiac Troponin T

10. november 2026 opdateret af: Rasmus Bo Hasselbalch

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

Rekruttering

Betingelser

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

Interventionel

Tilmelding (Anslået)

22600

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

      • Herlev, Danmark, 2730
        • Ikke rekrutterer endnu
        • Copenhagen University Hospital - Herlev and Gentofte Hospital
        • Kontakt:
      • Horsens, Danmark, 8700
      • Kolding, Danmark, 6000
      • København NV, Danmark, 2400
        • Ikke rekrutterer endnu
        • Copenhagen University Hospital - Bispebjerg
        • Kontakt:
      • København Ø, Danmark, 2100
        • Ikke rekrutterer endnu
        • Copenhagen University Hospital - Rigshospitalet
        • Kontakt:
      • Odense, Danmark, 5000
      • Svendborg, Danmark, 5700
        • Ikke rekrutterer endnu
        • Odense Universitetshospital Svendborg Sygehus
        • Kontakt:
      • Sønderborg, Danmark, 6400

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

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

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Diagnostisk
  • Tildeling: Randomiseret
  • Interventionel model: Sekventiel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / 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

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

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

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

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

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

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. august 2026

Primær færdiggørelse (Anslået)

31. marts 2028

Studieafslutning (Anslået)

31. juli 2028

Datoer for studieregistrering

Først indsendt

4. november 2026

Først indsendt, der opfyldte QC-kriterier

10. november 2026

Først opslået (Faktiske)

13. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • F-26025642

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Due to restrictions within Danish and Norwegian law for registry data

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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