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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

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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. / Inoue, Kenji; Chieh, Jack Tan Wei; Yeh, Lim Chiw; Chiang, Shuo-Ju; Phrommintikul, Arintaya; Suwanasom, Pannipa; Kasim, Sazzli; Ahmad, Bakhtiar; Idrose, Alzamani Mohammad; Salleh, Farina Mohd; Oyamada, Shunsuke; Hirano, Yohei; Ouchi, Shohei; Terakura, Moriyuki; Yokoyama, Naoyuki; Kozuma, Ken; Nanasato, Mamoru; Higuchi, Ryosuke; Yumoto, Kazuhiko; Fukuzawa, Tomoyuki; Shimada, Issei; Giannitsis, Evangelos; Twerenbold, Raphael; Minamino, Tohru.

In: TRIALS, Vol. 23, No. 1, 07.12.2022, p. 986.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Inoue, K, Chieh, JTW, Yeh, LC, Chiang, S-J, Phrommintikul, A, Suwanasom, P, Kasim, S, Ahmad, B, Idrose, AM, Salleh, FM, Oyamada, S, Hirano, Y, Ouchi, S, Terakura, M, Yokoyama, N, Kozuma, K, Nanasato, M, Higuchi, R, Yumoto, K, Fukuzawa, T, Shimada, I, Giannitsis, E, Twerenbold, R & Minamino, T 2022, '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', TRIALS, vol. 23, no. 1, pp. 986. https://doi.org/10.1186/s13063-022-06907-4

APA

Inoue, K., Chieh, J. T. W., Yeh, L. C., Chiang, S-J., Phrommintikul, A., Suwanasom, P., Kasim, S., Ahmad, B., Idrose, A. M., Salleh, F. M., Oyamada, S., Hirano, Y., Ouchi, S., Terakura, M., Yokoyama, N., Kozuma, K., Nanasato, M., Higuchi, R., Yumoto, K., ... Minamino, T. (2022). 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. TRIALS, 23(1), 986. https://doi.org/10.1186/s13063-022-06907-4

Vancouver

Inoue K, Chieh JTW, Yeh LC, Chiang S-J, Phrommintikul A, Suwanasom P et al. 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. TRIALS. 2022 Dec 7;23(1):986. https://doi.org/10.1186/s13063-022-06907-4

Bibtex

@article{bd90ea7b9dd44076bb7cd4962f4cbb50,
title = "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",
abstract = "BACKGROUND: More 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.METHODS: The 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.CONCLUSIONS: This 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.",
keywords = "Humans, Acute Coronary Syndrome/diagnosis, Prospective Studies, Asia/epidemiology",
author = "Kenji Inoue and Chieh, {Jack Tan Wei} and Yeh, {Lim Chiw} and Shuo-Ju Chiang and Arintaya Phrommintikul and Pannipa Suwanasom and Sazzli Kasim and Bakhtiar Ahmad and Idrose, {Alzamani Mohammad} and Salleh, {Farina Mohd} and Shunsuke Oyamada and Yohei Hirano and Shohei Ouchi and Moriyuki Terakura and Naoyuki Yokoyama and Ken Kozuma and Mamoru Nanasato and Ryosuke Higuchi and Kazuhiko Yumoto and Tomoyuki Fukuzawa and Issei Shimada and Evangelos Giannitsis and Raphael Twerenbold and Tohru Minamino",
note = "{\textcopyright} 2022. The Author(s).",
year = "2022",
month = dec,
day = "7",
doi = "10.1186/s13063-022-06907-4",
language = "English",
volume = "23",
pages = "986",
journal = "TRIALS",
issn = "1745-6215",
publisher = "Current Controlled Trials Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - 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

AU - Inoue, Kenji

AU - Chieh, Jack Tan Wei

AU - Yeh, Lim Chiw

AU - Chiang, Shuo-Ju

AU - Phrommintikul, Arintaya

AU - Suwanasom, Pannipa

AU - Kasim, Sazzli

AU - Ahmad, Bakhtiar

AU - Idrose, Alzamani Mohammad

AU - Salleh, Farina Mohd

AU - Oyamada, Shunsuke

AU - Hirano, Yohei

AU - Ouchi, Shohei

AU - Terakura, Moriyuki

AU - Yokoyama, Naoyuki

AU - Kozuma, Ken

AU - Nanasato, Mamoru

AU - Higuchi, Ryosuke

AU - Yumoto, Kazuhiko

AU - Fukuzawa, Tomoyuki

AU - Shimada, Issei

AU - Giannitsis, Evangelos

AU - Twerenbold, Raphael

AU - Minamino, Tohru

N1 - © 2022. The Author(s).

PY - 2022/12/7

Y1 - 2022/12/7

N2 - BACKGROUND: More 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.METHODS: The 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.CONCLUSIONS: This 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.

AB - BACKGROUND: More 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.METHODS: The 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.CONCLUSIONS: This 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.

KW - Humans

KW - Acute Coronary Syndrome/diagnosis

KW - Prospective Studies

KW - Asia/epidemiology

U2 - 10.1186/s13063-022-06907-4

DO - 10.1186/s13063-022-06907-4

M3 - SCORING: Journal article

C2 - 36476401

VL - 23

SP - 986

JO - TRIALS

JF - TRIALS

SN - 1745-6215

IS - 1

ER -