ClinicalTrials.gg
CompletedNCT03489603Updated Feb 26, 2021

Clinical and Economic Outcomes of High Sensitivity Troponin for no ST Elevation Myocardial Infarction in Patients With Chest Pain in Emergency Departments in Italy-An Observational Study

An observational study in NSTEMI - Non-ST Segment Elevation MI, sponsored by Marco Marchetti. Completed at 1 site in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-02-26.

Sponsored by Marco Marchetti · Observational

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Study type
Observational
Model
Other
Time perspective
Prospective
Enrollment
2,913
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 36 studies in Non-ST Elevated Myocardial Infarction with a site in Italy — 3 open to participants now, 8 under way, none of them phase 3. Non-ST Elevated Myocardial Infarction · Italy.

Enrollment
2nd of 13
2,913 · median 800
Started
2017
the only one that year
Observational
13 of 36
3 open now
Registered
21st of 36
by date

Among the 36 studies in Non-ST Elevated Myocardial Infarction with a site in Italy, this one is the 2nd largest by enrollment of the 13 observational ones that give a count, is the only one that started in 2017, is one of 13 observational ones, and was the 21st registered.

Non-ST Elevated Myocardial Infarction

284 studies on the registry are indexed under Non-ST Elevated Myocardial Infarction; 52 are open to participants now.

Browse Non-ST Elevated Myocardial Infarction studies →

Open to participants now

3 of the 36 studies in Non-ST Elevated Myocardial Infarction with a site in Italy are open now. Recruiting first, the newest first:

All 3 open studies →

A study can be open while its sites in Italy have not opened yet or have stopped. Only those recruiting at a site in Italy →

Who these studies take

Of the 40 Non-ST Elevated Myocardial Infarction studies recruiting now, 34 (85%) set no upper age limit and 1 (3%) stops at 75 or younger; 4 take children under 18; 2 take healthy volunteers.

This study: 18 Years and older · all sexes · no healthy volunteers.

The full table on the hub →

This tab as a report to print or save as PDF → With an account.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 36 studies in Non-ST Elevated Myocardial Infarction with a site in Italy, or all of them as a file.
02

Study summary

Myocardial infarction is one of the leading causes of death and disability worldwide. In addition to standard diagnostic methods, it has been shown that high-sensitivity cardiac troponin assays allow greater sensitivity in the diagnosis of myocardial infarction and assume a central role for both exclusion ("rule out") and confirmation ("rule in") of acute myocardial infarction , while allowing to reduce the time interval between ER admission and presumptive diagnosis.

Considering the relevance of this topic, we propose to conduct an observational study in real world clinical practice settings at Emergency Departments, aiming to evaluate clinical and economic aspects deriving from the use of the different quantitative assays of high-sensitivity cardiac troponin currently available in patients with suspected acute myocardial infarction and non-ST-elevation ECG (NSTEMI) on the admission, including time of diagnosis and number of laboratory and imaging tests performed.

Read the detailed description

Observational, prospective, real-world clinical practice, multicentric study, conducted at 12 Emergency Departments in Italy.

Patients with suspected non-ST-elevation myocardial infarction (NSTEMI) who have undergone at least one high-sensitivity cardiac troponin test will be included.

Patients will be enrolled in the study after verification of selection criteria.

Enrollment is consecutive; each Center will suspend enrollment when it has reached the expected number of patients.

An electronic data collection form (eCRF) will be used to automatically generate an enrollment number to identify each patient.

Given the observational nature of the study, high-sensitivity cardiac troponin assays will be used according to current clinical practice.

Patients will be examined in the ED, and on a 30-day follow-up.

03

Conditions studied

  • NSTEMI - Non-ST Segment Elevation MI

Keywords

  • Troponin
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients attending the Emergency Department with chest pain

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients with chest pain
  • Performing at least one cardiac troponin determination test
  • Written

Exclusion criteria

Exclusion Criteria:

  • Refusal to provide
  • Elevation of the ST segment to the
  • Pregnancy or breastfeeding
  • Any other clinical condition not judged by the investigator compatible with participation in the present study.
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

05

Study design

Observational model
Other
Time perspective
Prospective
Enrollment
2,913 participants (actual)
Patient registry
No
06

What researchers measure

Primary outcomes

  1. Time to diagnosis in the emergency department

    Time from admission at the emergency department and diagnosis or exclusion of NSTEMI

    Time frame: 1-3-6 hours

Secondary outcomes

  1. Number of ruled-in and ruled-out patients

    Number of patients diagnosed with NSTEMI and hospitalized, and number of patients discharged from the emergency room after exclusion of NSTEMI

    Time frame: 1-3-6 hours

  2. Number of tests performed

    Number of high-sensitivity cardiac troponin tests performed

    Time frame: 1-3-6 hours

  3. Number of patients diagnosed with a Major Adverse Clinical Event

    number of patients with myocardial infarction, stroke, or unplanned revascularization

    Time frame: 30 days after the first assessment

  4. 30-day mortality

    Death rate 30 days after admission to the emergency department

    Time frame: 30 days following admission

07

Study locations

1 site
  • Istituto Superiore di Sanità
    Roma, 00161, Italy
08

References and documents

Publications

  • Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD; Joint ESC/ACCF/AHA/WHF Task Force for Universal Definition of Myocardial Infarction; Authors/Task Force Members Chairpersons; Thygesen K, Alpert JS, White HD; Biomarker Subcommittee; Jaffe AS, Katus HA, Apple FS, Lindahl B, Morrow DA; ECG Subcommittee; Chaitman BR, Clemmensen PM, Johanson P, Hod H; Imaging Subcommittee; Underwood R, Bax JJ, Bonow JJ, Pinto F, Gibbons RJ; Classification Subcommittee; Fox KA, Atar D, Newby LK, Galvani M, Hamm CW; Intervention Subcommittee; Uretsky BF, Steg PG, Wijns W, Bassand JP, Menasche P, Ravkilde J; Trials & Registries Subcommittee; Ohman EM, Antman EM, Wallentin LC, Armstrong PW, Simoons ML; Trials & Registries Subcommittee; Januzzi JL, Nieminen MS, Gheorghiade M, Filippatos G; Trials & Registries Subcommittee; Luepker RV, Fortmann SP, Rosamond WD, Levy D, Wood D; Trials & Registries Subcommittee; Smith SC, Hu D, Lopez-Sendon JL, Robertson RM, Weaver D, Tendera M, Bove AA, Parkhomenko AN, Vasilieva EJ, Mendis S; ESC Committee for Practice Guidelines (CPG); Bax JJ, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S; Document Reviewers; Morais J, Aguiar C, Almahmeed W, Arnar DO, Barili F, Bloch KD, Bolger AF, Botker HE, Bozkurt B, Bugiardini R, Cannon C, de Lemos J, Eberli FR, Escobar E, Hlatky M, James S, Kern KB, Moliterno DJ, Mueller C, Neskovic AN, Pieske BM, Schulman SP, Storey RF, Taubert KA, Vranckx P, Wagner DR. Third universal definition of myocardial infarction. J Am Coll Cardiol. 2012 Oct 16;60(16):1581-98. doi: 10.1016/j.jacc.2012.08.001. Epub 2012 Sep 5. No abstract available. PubMed 22958960 ↗
  • Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, Bax JJ, Borger MA, Brotons C, Chew DP, Gencer B, Hasenfuss G, Kjeldsen K, Lancellotti P, Landmesser U, Mehilli J, Mukherjee D, Storey RF, Windecker S. [2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)]. G Ital Cardiol (Rome). 2016 Oct;17(10):831-872. doi: 10.1714/2464.25804. No abstract available. Italian. PubMed 27869901 ↗
  • Apple FS, Collinson PO; IFCC Task Force on Clinical Applications of Cardiac Biomarkers. Analytical characteristics of high-sensitivity cardiac troponin assays. Clin Chem. 2012 Jan;58(1):54-61. doi: 10.1373/clinchem.2011.165795. Epub 2011 Sep 30. Erratum In: Clin Chem. 2012 Apr;58(4):796. PubMed 21965555 ↗
  • Apple FS, Ler R, Murakami MM. Determination of 19 cardiac troponin I and T assay 99th percentile values from a common presumably healthy population. Clin Chem. 2012 Nov;58(11):1574-81. doi: 10.1373/clinchem.2012.192716. Epub 2012 Sep 14. PubMed 22983113 ↗
  • Shah AS, Anand A, Sandoval Y, Lee KK, Smith SW, Adamson PD, Chapman AR, Langdon T, Sandeman D, Vaswani A, Strachan FE, Ferry A, Stirzaker AG, Reid A, Gray AJ, Collinson PO, McAllister DA, Apple FS, Newby DE, Mills NL; High-STEACS investigators. High-sensitivity cardiac troponin I at presentation in patients with suspected acute coronary syndrome: a cohort study. Lancet. 2015 Dec 19;386(10012):2481-8. doi: 10.1016/S0140-6736(15)00391-8. Epub 2015 Oct 8. PubMed 26454362 ↗
  • Rubini Gimenez M, Twerenbold R, Jaeger C, Schindler C, Puelacher C, Wildi K, Reichlin T, Haaf P, Merk S, Honegger U, Wagener M, Druey S, Schumacher C, Krivoshei L, Hillinger P, Herrmann T, Campodarve I, Rentsch K, Bassetti S, Osswald S, Mueller C. One-hour rule-in and rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I. Am J Med. 2015 Aug;128(8):861-870.e4. doi: 10.1016/j.amjmed.2015.01.046. Epub 2015 Mar 31. PubMed 25840034 ↗
  • Shah AS, Griffiths M, Lee KK, McAllister DA, Hunter AL, Ferry AV, Cruikshank A, Reid A, Stoddart M, Strachan F, Walker S, Collinson PO, Apple FS, Gray AJ, Fox KA, Newby DE, Mills NL. High sensitivity cardiac troponin and the under-diagnosis of myocardial infarction in women: prospective cohort study. BMJ. 2015 Jan 21;350:g7873. doi: 10.1136/bmj.g7873. Erratum In: BMJ. 2015 Feb 03;350:h626. doi: 10.1136/bmj.h626. BMJ. 2016 Sep 06;354:i4840. doi: 10.1136/bmj.i4840. PubMed 25609052 ↗
  • Casagranda I, Cavazza M, Clerico A, Galvani M, Ottani F, Zaninotto M, Biasucci LM, Cervellin G, Lenzi T, Lippi G, Plebani M, Tubaro M. Proposal for the use in emergency departments of cardiac troponins measured with the latest generation methods in patients with suspected acute coronary syndrome without persistent ST-segment elevation. Clin Chem Lab Med. 2013 Sep;51(9):1727-37. doi: 10.1515/cclm-2013-0423. PubMed 23893689 ↗
  • Cremonesi P, Di Bella E, Montefiori M. Cost analysis of emergency department. J Prev Med Hyg. 2010 Dec;51(4):157-63. PubMed 21553561 ↗
  • Keller T, Zeller T, Ojeda F, Tzikas S, Lillpopp L, Sinning C, Wild P, Genth-Zotz S, Warnholtz A, Giannitsis E, Mockel M, Bickel C, Peetz D, Lackner K, Baldus S, Munzel T, Blankenberg S. Serial changes in highly sensitive troponin I assay and early diagnosis of myocardial infarction. JAMA. 2011 Dec 28;306(24):2684-93. doi: 10.1001/jama.2011.1896. PubMed 22203537 ↗
  • Reichlin T, Irfan A, Twerenbold R, Reiter M, Hochholzer W, Burkhalter H, Bassetti S, Steuer S, Winkler K, Peter F, Meissner J, Haaf P, Potocki M, Drexler B, Osswald S, Mueller C. Utility of absolute and relative changes in cardiac troponin concentrations in the early diagnosis of acute myocardial infarction. Circulation. 2011 Jul 12;124(2):136-45. doi: 10.1161/CIRCULATIONAHA.111.023937. Epub 2011 Jun 27. PubMed 21709058 ↗
  • Pickering JW, Greenslade JH, Cullen L, Flaws D, Parsonage W, George P, Worster A, Kavsak PA, Than MP. Validation of presentation and 3 h high-sensitivity troponin to rule-in and rule-out acute myocardial infarction. Heart. 2016 Aug 15;102(16):1270-8. doi: 10.1136/heartjnl-2015-308505. Epub 2016 Mar 8. PubMed 26955848 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Oct 2017 to primary completion in Jul 2018, 9 months.

Of 54 non-industry observational studies under Non-ST Elevated Myocardial Infarction, half reached primary completion within 40 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 86. This study's 9 months is below that.

Counting every sponsor, half of 76 studies reached it within 32 months; a quarter within 19 and three quarters within 49.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 15, 2018
First posted
Apr 5, 2018
StartActual
Oct 11, 2017
Primary completionActual
Jul 11, 2018
CompletionActual
Jun 15, 2019
Last update
Feb 26, 2021
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 26, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03489603
Lead sponsor
Marco Marchetti
Collaborators
Azienda Ospedaliero Universitaria Maggiore della Carita, Azienda Sanitaria Locale ASL 6, Livorno, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Ospedale Civile - Padova, S. Andrea Hospital, Azienda Policlinico Umberto I, San Carlo Public Hospital, Potenza, Italy, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Policlinico Universitario, Catania, Azienda Ospedaliera Sant'Anna, Ospedale di Cattinara - Azienda Universitaria Integrata -Trieste, Abbott, Informapro Srl
Responsible party
Marco Marchetti (Director of the National Health Technology Assessment Centre, Istituto Superiore di Sanità) — Sponsor-investigator
First posted
Apr 5, 2018
Start date
Oct 11, 2017
Primary completion
Jul 11, 2018
Completion
Jun 15, 2019
Last update
Feb 26, 2021

Study contacts

Marco Marchetti, MD
principal investigator · Istituto Superiore di Sanità

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2021. You cannot join it, but the record below documents what was studied.

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