Evidence map›Paper›PMID 36476401›Full record

Trial reportTrials2022

An international, stepped wedge, cluster-randomized trial investigating the 0/1-h algorithm in suspected acute coronary syndrome in Asia: the rational of the DROP-Asian ACS study.

Kenji Inoue, Jack Tan Wei Chieh, Lim Chiw Yeh, Shuo-Ju Chiang, Arintaya Phrommintikul, Pannipa Suwanasom, Sazzli Kasim, Bakhtiar Ahmad, Alzamani Mohammad Idrose, Farina Mohd Salleh and 14 more

Erratum issuedOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors at 14 institutions in 6 countries.

Kenji InoueDepartment of Cardiovascular Biology and Medicine, Juntendo University Nerima Hospital, Tokyo, Japan. inouelsbm@gmail.com.ORCID http://orcid.org/0000-0002-7193-8421
Jack Tan Wei ChiehDepartment of Cardiology, National Heart Centre Singapore and Sengkang General Hospital, Singapore, Singapore.
Lim Chiw YehDepartment of Cardiology, National Heart Centre Singapore and Sengkang General Hospital, Singapore, Singapore.
Shuo-Ju ChiangDivision of Cardiology, Department of Internal Medicine, Taipei City Hospital Yangming Branch, Taipei, Taiwan.
Arintaya PhrommintikulDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiangmai, Thailand.
Pannipa SuwanasomDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiangmai, Thailand.
Sazzli KasimDivision of Cardiology, Hospital Al-Sultan Abdullah, University Teknologi MARA, Kuala Lumpur, Malaysia.
Bakhtiar AhmadDivision of Cardiology, Hospital Al-Sultan Abdullah, University Teknologi MARA, Kuala Lumpur, Malaysia.
Alzamani Mohammad IdroseDivision of Emergency, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
Farina Mohd SallehDivision of Emergency, Institut Jantung Negara, Kuala Lumpur, Malaysia.
Shunsuke OyamadaDepartments of Biostatistics, JORTC Data Center, Tokyo, Japan.
Yohei HiranoDepartment of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Chiba, Japan.
Shohei OuchiDepartment of Cardiovascular Biology and Medicine, Juntendo Urayasu Hospital, Chiba, Japan.
Moriyuki TerakuraDepartment of Emergency, Teikyo University School of Medicine, Tokyo, Japan.
Naoyuki YokoyamaDepartment of Cardiology, Teikyo University School of Medicine, Tokyo, Japan.
Ken KozumaDepartment of Cardiology, Teikyo University School of Medicine, Tokyo, Japan.
Mamoru NanasatoDepartment of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
Ryosuke HiguchiDepartment of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
Kazuhiko YumotoDepartment of Cardiology, Yokohama Rosai Hospital, Kanagawa, Japan.
Tomoyuki FukuzawaDepartment of Cardiology, Yokohama Rosai Hospital, Kanagawa, Japan.
Issei ShimadaShimada General Hospital, Chiba, Japan.
Evangelos GiannitsisDepartment of Cardiology, University Hospital Heidelberg, Heidelberg, Germany.
Raphael TwerenboldDepartment of Cardiology and University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, Hamburg, Germany.
Tohru MinaminoDepartment of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Teikyo University · JPChiang Mai University · THJuntendo University Urayasu Hospital · JPNational Heart Centre Singapore · SGSakakibara Hospital · JPYokohama Rosai Hospital · JPHeidelberg University · DEHospital Kuala Lumpur · MYJuntendo University · JPJuntendo University Nerima Hospital · JPNational Heart Institute · MYResearch Organization of Information and Systems · JPShimada Municipal Hospital · JPTaipei City Hospital · TW

Funding

Grant-in-Aid for Scientific Research 18K09954
6 · The paper itself

Abstract

backgroundMore than half of the world's population lives in Asia. With current life expectancies in Asian countries, the burden of cardiovascular disease is increasing exponentially. Overcrowding in the emergency departments (ED) has become a public health problem. Since 2015, the European Society of Cardiology recommends the use of a 0/1-h algorithm based on high-sensitivity cardiac troponin (hs-cTn) for rapid triage of patients with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). However, these algorithms are currently not recommended by Asian guidelines due to the lack of suitable data.

methodsThe DROP-Asian ACS is a prospective, stepped wedge, cluster-randomized trial enrolling 4260 participants presenting with chest pain to the ED of 12 acute care hospitals in five Asian countries (UMIN; 000042461). Consecutive patients presenting with suspected acute coronary syndrome between July 2022 and Apr 2024 were included. Initially, all clusters will apply "usual care" according to local standard operating procedures including hs-cTnT but not the 0/1-h algorithm. The primary outcome is the incidence of major adverse cardiac events (MACE), the composite of all-cause death, myocardial infarction, unstable angina, or unplanned revascularization within 30 days. The difference in MACE (with one-sided 95% CI) was estimated to evaluate non-inferiority. The non-inferiority margin was prespecified at 1.5%. Secondary efficacy outcomes include costs for healthcare resources and duration of stay in ED.

conclusionsThis study provides important evidence concerning the safety and efficacy of the 0/1-h algorithm in Asian countries and may help to reduce congestion of the ED as well as medical costs.

Indexed as

Acute Coronary SyndromeAsiaHumansProspective Studies0-h/1-h algorithmHigh-sensitivity troponin TNon-ST elevation of acute coronary syndromeOvercrowding emergency department

Identifiers

PMID36476401
PMCPMC9727900
OpenAlexW4311577975

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.