Site (All UK) | High-sensitivity troponin assay | Risk stratification tool and definition of low-risk | Troponin assay sampling times for low-risk patients | Troponin assay result to allow discharge if low-risk |
Sites not using the LoD cut-off within usual rule-out strategies | ||||
Royal United Hospital, Bath | Roche Elecsys hs-cTnT* | GRACE28 score <1.5% six month mortality | Presentation and after 6 hours (or 6 hours from onset of pain) | Both results <14 ng/L OR 14–30 ng/L and no change >20% between tests |
Southmead Hospital, Bristol | Roche Elecsys hs-cTnT* | TIMI score <2 | Presentation and after 2 hours | Both results <14 ng/L OR 14–30 ng/L and no change >20% between tests |
Derriford Hospital, Plymouth | Abbott Architect hs-cTnI† | HEART26 score ≤3 | Presentation and after 3 hours | Both results <99th percentile (sex-specific)† |
University Hospital, Southampton | Beckman-Coulter Access hs-cTnI‡ | TIMI29 score <2 | Presentation and after 3 hours | Both results <18 ng/L |
Sites using the LoD cut-off within usual rule-out strategies | ||||
University Hospital of Wales, Cardiff | Abbott Architect hs-cTnI† | HEART26 score ≤2 | Presentation and after 3 hours | Presentation <2 ng/L (LoD) and >2 hours after symptom onset OR both results <99th percentile (sex-specific)† |
Royal Devon and Exeter Hospital, Exeter | Roche Elecsys hs-cTnT* | Absence of ECG changes and unstable angina symptoms | Presentation and after 1 hour | Presentation <5 ng/L (LoD) and >3 hours after symptom onset OR both results <14 ng/L |
Royal London Hospital, Barts Health NHS Trust, London | Roche Elecsys hs-cTnT* | HEART26 score ≤3 | Presentation and after 3 hours | Presentation <5 ng/L (LoD) OR both results <14 ng/L |
Royal Berkshire Hospital, Reading | Roche Elecsys hs-cTnT* | HEART26 score ≤3 | Presentation and after 1 hour | Presentation <5 ng/L (LoD) and >3 hours after symptom onset OR both results <14 ng/L |
*Roche Elecsys hs-cTnT. This assay has a 99th percentile value of 14 ng/L and LoD of 5 ng/L.
†Abbott Architect hs-cTnI. This assay has 99th percentile value of 34 ng/L in men and 16 ng/L in women and LoD of 2 ng/L.
‡Beckman-Coulter Access hs-cTnI. This assay has a 99th percentile value of 18 ng/L and LoD of 2 ng/L.
GRACE, Global Registry of Acute Coronary Events; HEART, history, ECG, age, risk factors, troponin; hs-cTnI, high-sensitivity cardiac troponin I; hs-cTnT, high-sensitivity cardiac troponin T; LoD, limit of detection; TIMI, Thrombolysis In Myocardial Infarction.