Trial reportEuropean heart journal. Quality of care & clinical outcomes2024
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.
Trial report in European heart journal. Quality of care & clinical outcomes, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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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.
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Who cites it
7 citing papers in PubMed.
- Comparison of Troponin in a Prehospital Blood Sample and Risk Scores.Diagnostics (Basel, Switzerland) · 2026Article
- 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
- Cardiac troponin at the point of care in acute and chronic coronary syndromes.Diabetes, obesity & metabolism · 2025Review
- A novel rapid rule-out protocol for acute chest pain using H-FABP point-of-care testing.Scientific reports · 2025Article
- [Association of Serum Myeloperoxidase and Lipid Levels With Coronary Artery Lesion Severity and Major Adverse Cardiovascular Events in Patients With Acute Coronary Syndrome].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2025Article
- High-Sensitivity Cardiac Troponin Assays: From Implementation to Resource Utilization and Cost Effectiveness.The journal of applied laboratory medicine · 2025Review
- How Close Are We to Patient-Side Troponin Testing?Journal of clinical medicine · 2024Review
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Authors and funding
18 authors.
Funding
Abstract
BACKGROUND AND
aimsThe healthcare burden of acute chest pain is enormous. In the randomized ARTICA trial, we showed that pre-hospital identification of low-risk patients and rule-out of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) with point-of-care (POC) troponin measurement reduces 30-day healthcare costs with low major adverse cardiac events (MACE) incidence. Here we present the final 1-year results of the ARTICA trial.
methodsLow-risk patients with suspected NSTE-ACS were randomized to pre-hospital rule-out with POC troponin measurement or emergency department (ED) transfer. Primary 1-year outcome was healthcare costs. Secondary outcomes were safety, quality of life (QoL), and cost-effectiveness. Safety was defined as a 1-year MACE consisting of ACS, unplanned revascularization, or all-cause death. QoL was measured with EuroQol-5D-5L questionnaires. Cost-effectiveness was defined as 1-year healthcare costs difference per QoL difference.
resultsFollow-up was completed for all 863 patients. Healthcare costs were significantly lower in the pre-hospital strategy (€1932 ± €2784 vs. €2649 ± €2750), mean difference €717 [95% confidence interval (CI) €347 to €1087; P < 0.001]. In the total population, the 1-year MACE rate was comparable between groups [5.1% (22/434) in the pre-hospital strategy vs. 4.2% (18/429) in the ED strategy; P = 0.54]. In the ruled-out ACS population, 1-year MACE remained low [1.7% (7/419) vs. 1.4% (6/417)], risk difference 0.2% (95% CI -1.4% to 1.9%; P = 0.79). QoL showed no significant difference between strategies.
conclusionsPre-hospital rule-out of NSTE-ACS with POC troponin testing in low-risk patients is cost-effective, as expressed by a sustainable healthcare cost reduction and no significant effect on QoL. One-year MACE remained low for both strategies.
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