ArticleBMJ open2020
Acute rule-out of non-ST-segment elevation acute coronary syndrome in the (pre)hospital setting by HEART score assessment and a single point-of-care troponin: rationale and design of the ARTICA randomised trial.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Pre-hospital rule-out of non-ST-segment elevation acute coronary syndrome by a single troponin: final one-year outcomes of the ARTICA randomised trial.European heart journal. Quality of care & clinical outcomes · 2024Trial
- Rule-out of non-ST-segment elevation acute coronary syndrome by a single, pre-hospital troponin measurement: a randomized trial.European heart journal · 2023Trial
- Recruitment capacity and operational barriers to prehospital cardiac electrical biomarker acquisition: an ambulance-based pilot study.BMC cardiovascular disorders · 2026Observational
- Performance of the HEART Score in pre-hospital settings for suspected non-ST-elevation acute coronary syndrome: The POPular HEART Study.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2026Article
- Agreement between ambulance paramedics and physicians on the (pre)hospital identification of low-risk chest pain patients.European journal of emergency medicine : official journal of the European Society for Emergency Medicine · 2026Article
- Pre-hospital admission of heparin in patients with suspected non-ST segment elevation acute coronary syndrome.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Article
- Point-of-care tests in the emergency medical services: a scoping review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Article
- Pre-hospital evaluation of chest pain patients using the modified HEART-score: rationale and design.Future cardiology · 2024Observational
- Differences in risk and costs between prehospital identified low-risk men and women with chest pain.Open heart · 2023Article
- AI Algorithm to Predict Acute Coronary Syndrome in Prehospital Cardiac Care: Retrospective Cohort Study.JMIR cardio · 2023Article
- Acute Chest Pain—Diagnostic Accuracy and Pre-Hospital Use of Anticoagulants and Platelet Aggregation InhibitorsDeutsches Arzteblatt international · 2023Article
- Improved prehospital triage for acute cardiac care: results from HART-c, a multicentre prospective study.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2023Article
- Point-of-care testing with high-sensitivity cardiac troponin assays: the challenges and opportunities.Emergency medicine journal : EMJ · 2022Review
- Pre-hospital rule-out of acute coronary syndrome by modified HEART score assessment including point-of-care troponin.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2022Article
- Brazilian Society of Cardiology Guidelines on Unstable Angina and Acute Myocardial Infarction without ST-Segment Elevation - 2021.Arquivos brasileiros de cardiologia · 2021 · on this mapArticle
- Performance of a simplified HEART score and HEART-GP score for evaluating chest pain in urgent primary care.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2021Article
- Prehospital triage of patients with acute cardiac complaints: study protocol of HART-c, a multicentre prospective study.BMJ open · 2021Article
- Pre-hospital point-of-care troponin measurement: a clinical example of its additional value.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2020Review
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionBecause of the lack of prehospital protocols to rule out a non-ST-segment elevation acute coronary syndrome (NSTE-ACS), patients with chest pain are often transferred to the emergency department (ED) for thorough evaluation. However, in low-risk patients, an ACS is rarely found, resulting in unnecessary healthcare consumption. Using the HEART (History, ECG, Age, Risk factors and Troponin) score, low-risk patients are easily identified. When a point-of-care (POC) troponin measurement is included in the HEART score, an ACS can adequately be ruled out in low-risk patients in the prehospital setting. However, it remains unclear whether a prehospital rule-out strategy using the HEART score and a POC troponin measurement in patients with suspected NSTE-ACS is cost-effective. METHODS AND ANALYSIS: The ARTICA trial is a randomised trial in which the primary objective is to investigate the cost-effectiveness after 30 days of an early rule-out strategy for low-risk patients suspected of a NSTE-ACS, using a modified HEART score including a POC troponin T measurement. Patients are included by ambulance paramedics and 1:1 randomised for (1) presentation at the ED (control group) or (2) POC troponin T measurement (intervention group) and transfer of the care to the general practitioner in case of a low troponin T value. In total, 866 patients will be included. Follow-up will be performed after 30 days, 6 months and 12 months. ETHICS AND DISSEMINATION: This trial has been accepted by the Medical Research Ethics Committee region Arnhem-Nijmegen. The results of this trial will be disseminated in one main paper and in additional papers with subgroup analyses. TRIAL REGISTRATION NUMBER: Netherlands Trial Register (NL7148).
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