Methodology: 3.5/5
Usefulness: 3.5/5

Anand A, et al. Circulation. 2021 Jun 8;143(23):2214-2224. 

Raising the Bar for Clinical Cardiac Troponin Research Studies and Implementation Science. 

Question and Methods: Does implementation of an early rule-out (ERO) strategy using high-sensitivity troponin I reduce length of stay (LOS) and maintain safety outcomes at 30 days and 1 year.
Findings: LOS was reduced by 3.3 hours (95% CI, 0.73–0.83; P<0.001) and hospital admission reduced by 21% adjusted OR, 1.59 [95% CI,1.45–1.75]. 
Limitations: Enrolment targets not met, and standard of care required repeat troponin at 6 or 12 hours.  

Interpretation: An early rule-out strategy using hs-cTn is effective at reducing ED LOS (at centres retesting 6/12 hours) for ACS and is safe to use.

By: Dr. Alex Viau

JC Supervisor: Dr. Venkatesh Thiruganasambandamoorthy



  • Alex Viau

    Dr. Alex Viau is a FRCPC Emergency Medicine resident in the Department of Emergency Medicine, University of Ottawa.

    View all posts
  • Hans Rosenberg

    Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.

    View all posts
  • Venkatesh Thiruganasambandamoorthy

    Dr. Venkatesh Thiruganasambandamoorthy is an attending physician and associate scientist at the Ottawa Hospital and Ottawa Hospital Research Institute with an particular interest in syncope and presyncope care.

    View all posts