People with chest pain are often tested for a heart attack using a blood test called high-sensitivity cardiac troponin (hs-cTn). Traditionally, this blood test is repeated 3 hours after the first sample. Newer guidelines recommend repeating the test after 1 hour instead, which may allow patients to receive a diagnosis and leave the hospital sooner.
The purpose of the DanRUSH trial is to compare these two strategies: repeating the blood test after 1 hour versus after 3 hours in adults with suspected acute coronary syndrome. The study will evaluate whether the 1-hour strategy is as safe as the 3-hour strategy while reducing the length of hospital stay.
DanRUSH is a nationwide, pragmatic, cluster-randomized trial conducted in emergency- and cardiology departments across Denmark. The results will help determine the best timing for blood testing in patients with suspected heart attack and improve future care for these patients.
Adults (≥18 years) presenting with suspected acute coronary syndrome (ACS) with a clinical indication for high-sensitivity cardiac troponin testing
Age <18 years.
ST-segment elevation myocardial infarction (STEMI) identified on the presenting electrocardiogram and requiring immediate reperfusion therapy.
Parallel
0/3-hour high-sensitivity cardiac troponin algorithm
Diagnostic testHigh-sensitivity cardiac troponin measurements obtained at presentation and 3 hours after the initial sample as part of the conventional diagnostic strategy for suspected acute coronary syndrome.
0/1-hour high-sensitivity cardiac troponin algorithm
Diagnostic testHigh-sensitivity cardiac troponin measurements obtained at presentation and 1 hour after the initial sample as part of the accelerated diagnostic strategy for suspected acute coronary syndrome.
Safety outcome: New myocardial infarction or cardiovascular death
The risk of new (missed or recurrent) myocardial infarction or cardiovascular death after dischage -of the 0/1-hour algorithm compared with the 0/3-hour algorithm.
Efficacy outcome: Length of hospital stay
Length of stay, defined as the time from presentation to the emergency department until discharge from hospital.
New myocardial infarction at 12 months
New myocardial infarction within 12 months following discharge from the index hospitalization, excluding myocardial infarction diagnosed during the index hospitalization.
All-cause mortality
Death from any cause following discharge from the index hospitalization
Overall myocardial infarction rate
Occurrence of myocardial infarction during follow-up
Diagnostic coronary angiography
Performance of diagnostic coronary angiography following the index presentation
Click on the lead sponsor to view all of their trials.
Herlev and Gentofte Hospital
Lead sponsor
Bispeberg and Frederiksberg Hospital
Collaborator
Hvidovre and Amager Hospital
Collaborator
North Zealand (Hillerød) Hospital
Collaborator
Nykøbing Falster Sygehus
Collaborator
Gødstrup Hospital
Collaborator
Regionshospitalet Viborg, Skive
Collaborator
Odense Universitetshospital
Collaborator
Esbjerg sygehus
Collaborator
Aalborg University Hospital
Collaborator
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