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.
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Detaljert 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.
Studietype
Studietype
Registrering (Antatt)
Registrering
Fase
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiekontakt
Studiekontakt
- Navn: Rasmus B Hasselbalch, MD, PhD
- Telefonnummer: +45 38683868
- E-post: rasmus.bo.hasselbalch@regionh.dk
Studer Kontakt Backup
- Navn: Kristin Aakre, MD, PhD
- E-post: kristin.moberg.aakre@helse-bergen.no
Studiesteder
-
-
-
Herlev, Danmark, 2730
- Har ikke rekruttert ennå
- Copenhagen University Hospital - Herlev and Gentofte Hospital
-
Ta kontakt med:
- Kasper Iversen, Md, Dmsc
- Telefonnummer: +45 38683868
- E-post: Kasper.karmark.iversen@regionh.dk
-
Horsens, Danmark, 8700
- Har ikke rekruttert ennå
- Regionshospitalet Horsens
-
Ta kontakt med:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: +45 35453545
- E-post: rasmus.bo.hasselbalch@regionh.dk
-
Kolding, Danmark, 6000
- Har ikke rekruttert ennå
- Sygehus Lillebælt
-
Ta kontakt med:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: 35453545
- E-post: rasmus.bo.hasselbalch@regionh.dk
-
København NV, Danmark, 2400
- Har ikke rekruttert ennå
- Copenhagen University Hospital - Bispebjerg
-
Ta kontakt med:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: +45 35453545
- E-post: rasmus.bo.hasselbalch@regionh.dk
-
København Ø, Danmark, 2100
- Har ikke rekruttert ennå
- Copenhagen University Hospital - Rigshospitalet
-
Ta kontakt med:
- Rasmus Hasselbalch
- Telefonnummer: +45 34453545
- E-post: rasmus.bo.hasselbalch@regionh.dk
-
Odense, Danmark, 5000
- Rekruttering
- Odense Universitetshospital
-
Ta kontakt med:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: +45 35453545
- E-post: rasmus.bo.hasselbalch@regionh.dk
-
Svendborg, Danmark, 5700
- Har ikke rekruttert ennå
- Odense Universitetshospital Svendborg Sygehus
-
Ta kontakt med:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: +45 35453545
- E-post: rasmus.bo.hasselbalch@regionh.dk
-
Sønderborg, Danmark, 6400
- Har ikke rekruttert ennå
- Sygehus Sønderjylland
-
Ta kontakt med:
- Rasmus Hasselbalch, Md, PhD
- Telefonnummer: +45 35453545
- E-post: rasmus.bo.hasselbalch@regionh.dk
-
-
-
-
-
Bergen, Norge, 5009
- Har ikke rekruttert ennå
- Haraldsplass Diakonale sykehus
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Haukeland, Norge, 5009
- Har ikke rekruttert ennå
- Haukeland Universitetshospital
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Hønefoss, Norge, 3511
- Har ikke rekruttert ennå
- Vestre Viken HF
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Kristiansand, Norge, 4604
- Har ikke rekruttert ennå
- Sørlandet Sykehus HF
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Lørenskog, Norge, 1478
- Har ikke rekruttert ennå
- Akershus Universitetssykehus HF
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Nydalen, Norge, 4950
- Har ikke rekruttert ennå
- Oslo Universitetssykehus HF
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Oslo, Norge, 0370
- Har ikke rekruttert ennå
- Diakonhjemmet Sykehus
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Oslo, Norge, 0456
- Har ikke rekruttert ennå
- Lovisenberg Sykehus
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Stavanger, Norge, 4011
- Har ikke rekruttert ennå
- Helse Stavanger HF - Stavanger universitetssjukehus
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Tromsø, Norge, 9019
- Rekruttering
- Universitetssykehuset Nord-Norge HF
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Trondheim, Norge, 7030
- Har ikke rekruttert ennå
- St. Olavs Hospital HF
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Tønsberg, Norge, 3103
- Har ikke rekruttert ennå
- Sykehuset i Vestfold HF
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Ålesund, Norge, 6017
- Har ikke rekruttert ennå
- Ålesund sjukehus
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: +47 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
Ålesund, Norge, 6026
- Rekruttering
- Helse Møre og Romsdal HF
-
Ta kontakt med:
- Kristin Aakre, Md, PhD
- Telefonnummer: 55975000
- E-post: kristin.moberg.aakre@helse-bergen.no
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Barn
- Voksen
- Eldre voksen
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
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 studiet utformet?
Designdetaljer
- Primært formål: Diagnostisk
- Tildeling: Randomisert
- Intervensjonsmodell: Sekvensiell tildeling
- Masking: Enkelt
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / 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 |
|
Eksperimentell: 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 |
Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
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 |
Tiltaksbeskrivelse |
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 |
Tiltaksbeskrivelse |
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)
|
Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Samarbeidspartnere
Samarbeidspartnere
Etterforskere
Etterforskere
- Hovedetterforsker: Kristin Aakre, MD, PhD, Haukeland University Hospital
- Hovedetterforsker: Kasper Iversen, MD, Dmsc, Copenhagen University Hospital - Herlev and Gentofte Hospital
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Studiestart
Primær fullføring (Antatt)
Primær fullføring
Studiet fullført (Antatt)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
Andre studie-ID-numre
- F-26025642
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
IPD-planbeskrivelse
Due to restrictions within Danish and Norwegian law for registry data
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Studerer et amerikansk FDA-regulert enhetsprodukt
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .