Aiming Towards Evidence Based Interpretation of Cardiac Biomarkers in Patients Presenting With Chest Pain

NCT ID: NCT02620202

Last Updated: 2021-04-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Total Enrollment

1900 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-09-30

Study Completion Date

2020-05-31

Brief Summary

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The main aim of the WESTCOR study is to

* investigate the ability of two high sensitive cardiac troponin (hs-cTn) assays to diagnose acute coronary syndrome and predict prognosis in different patient populations (e.g. gender, age and co-morbidity)
* to validate the suggested 1 hour protocol for rule in and rule out of acute coronary syndrome for two hs-cTn assays in an unselected chest pain population
* to investigate different biomarkers ability to predict long term prognosis after hospitalization for chest pain

Detailed Description

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The WESTCOR-study will include patients presenting to the Emergency Department of Haukeland University Hospital and Stavanger University Hospital with symptoms indicative of acute coronary syndrome. 1500 patients will be included at Haukeland University Hospital and 400 at Stavanger University Hospital. The two locations use different high sensitive troponin assays (i.e. hs-cTnT and hs-cTnI (Abbott Diagnostics) for routine diagnostic of coronary syndrome.

1900 patients will be sampled and hs-cTnT or hs-cTnI (as applicable) will be measured at admission, after one (2/3 of the cohort), three hours and after 8-12 hours. Clinicians will be blinded to the results of the hs-cTn assay that is not used as routine assay locally. Final diagnosis will be made by two independent cardiologists based on all available clinical information and results of the routine tests. The ability to diagnose or exclude MI ACS, and MACE at different sampling points in different patient populations will be compared for different biomarkers. 1500 patients will have a sample 1 hour after admission. The clinicians will be blinded to the results of this sample (both hs-cTn assays). The ability of the one-hour sample to diagnose or exclude myocardial infraction (MI), ACS and MACE will be compared between biomarkers.

All patients will be invited to take a follow-up sample 3 months after discharge.

The patients will further be followed for 1-5 years through national registers and the prognostic value of hs-cTn concentrations and dynamics as well as other biomarkers, will be measured.

Conditions

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Acute Coronary Syndrome

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Eligibility Criteria

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Inclusion Criteria

* Patients admitted to the Emergency Department with a clinical suspicion of acute coronary syndrome i.e. chest pain or pain radiating down the arms, the back, into the jaw, throat or into the lower teeth. Chest pain must not be the most dominant symptom but may or may not be combined with e.g. dyspnea, nausea, anxiousness or palpitations.
* Age \>= 18 years

Exclusion Criteria

* ST elevation MI
* Age \< 18 years
* Patients not able to give informed consent
* Patients suffering from terminal illness (life expectance \< 1 month)
* Patients already included in the study
* Patients who have been stabilized at local hospitals and are referred for second opinion e.g. coronary angiography
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Helse Stavanger HF

OTHER_GOV

Sponsor Role collaborator

The Royal Norwegian Ministry of Health

OTHER

Sponsor Role collaborator

Haukeland University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kristin M Aakre, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Laboratory of Clinical Biochemistry, Haukeland University Hospital

Locations

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Haukeland University Hospital

Bergen, , Norway

Site Status

Stavanger University Hospital

Stavanger, , Norway

Site Status

Countries

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Norway

References

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Saeed N, Restan IZ, Steiro OT, Tjora HL, Langorgen J, Skadberg O, Mjelva OR, Bonarjee VVS, Bjorneklett RO, Steinsvik T, Vikenes K, Omland T, Apple FS, Jaffe AS, Mills NL, Collinson PO, Kavsak PA, Aakre KM. Analytical Error of Cardiac Troponin and Impact on the Performance of Accelerated Diagnostic Protocols in Patients with Acute Chest Pain. Clin Chem. 2025 Oct 14:hvaf116. doi: 10.1093/clinchem/hvaf116. Online ahead of print.

Reference Type DERIVED
PMID: 41092105 (View on PubMed)

Saeed N, Steiro OT, Langorgen J, Tjora HL, Bjorneklett RO, Skadberg O, Bonarjee VVS, Mjelva OR, Norekval TM, Steinsvik T, Vikenes K, Omland T, Aakre KM. Diagnosing Myocardial Injury in an Acute Chest Pain Cohort; Long-Term Prognostic Implications of Cardiac Troponin T and I. Clin Chem. 2024 Oct 3;70(10):1241-1255. doi: 10.1093/clinchem/hvae110.

Reference Type DERIVED
PMID: 39119917 (View on PubMed)

Saeed N, Norekval TM, Steiro OT, Tjora HL, Langorgen J, Bjorneklett RO, Skadberg O, Bonarjee VVS, Mjelva OR, Omland T, Vikenes K, Aakre KM. Predictors of long-term symptom burden and quality of life in patients hospitalised with chest pain: a prospective observational study. BMJ Open. 2022 Jul 13;12(7):e062302. doi: 10.1136/bmjopen-2022-062302.

Reference Type DERIVED
PMID: 35831040 (View on PubMed)

Steiro OT, Aakre KM, Tjora HL, Bjorneklett RO, Skadberg O, Bonarjee VVS, Mjelva OR, Omland T, Vikenes K, Langorgen J. Association between symptoms and risk of non-ST segment elevation myocardial infarction according to age and sex in patients admitted to the emergency department with suspected acute coronary syndrome: a single-centre retrospective cohort study. BMJ Open. 2022 May 12;12(5):e054185. doi: 10.1136/bmjopen-2021-054185.

Reference Type DERIVED
PMID: 35551077 (View on PubMed)

Other Identifiers

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2014/1365

Identifier Type: -

Identifier Source: org_study_id

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