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Trial registered on ANZCTR
Registration number
ACTRN12625000710426
Ethics application status
Approved
Date submitted
16/12/2024
Date registered
4/07/2025
Date last updated
4/07/2025
Date data sharing statement initially provided
4/07/2025
Type of registration
Retrospectively registered
Titles & IDs
Public title
A study to asses if a new Point-of-Care test could potentially improve care for patients suspected of having a heart attack.
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Scientific title
Improving care for possible myocardial infarction by determining the precision of a next generation i-STAT High Sensitivity Troponin-I point-of-care test in patients presenting with possible acute coronary syndrome in the emergency department
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Secondary ID [1]
313527
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None
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Universal Trial Number (UTN)
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Trial acronym
ICare-MI POC
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute Myocardial Infarction
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Acute Coronary Syndrome
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Condition category
Condition code
Cardiovascular
332556
332556
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0
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Other cardiovascular diseases
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Emergency medicine
332557
332557
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0
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Other emergency care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
In patients within an emergency department being investigated for possible myocardial infarction an additional blood test will be performed with the i-STAT High Sensitivity Troponin-I (i-STAT hs-TnI) assay. The results will not be made available to attending physicians and will not be used in clinical care.
Blood will be drawn by a researcher (nurse) and immediately assayed with the i-STAT hs-TnI. There is no other patient participation.
Data from the medical record will be collected for 30 days.
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Intervention code [1]
330104
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Early detection / Screening
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Major adverse cardiac event (MACE) rate per presentation within 30 days for patients discharged directly from ED and the rates for each individual component of MACE. MACE is defined as: (1) cardiac death (adjudicated) OR (2) Acute Myocardial Infarction (AMI): ST-segment Elevation Myocardial Infarction (STEMI), Non-ST-segment Elevation Myocardial Infarction (NSTEMI), Type 1 and Type 2 (adjudicated)
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Assessment method [1]
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MACE will be adjudicated by chart review. Two doctors will independently review the charts. They will be blinded to the assay being evaluated. In case of disagreement, a third, senior cardiologist, will provide the final adjudication.
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Timepoint [1]
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30 days post test.
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Secondary outcome [1]
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Possible adverse reactions are bruising at the site of blood draw.
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Assessment method [1]
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Recorded by the research nurse or in the ED records.
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Timepoint [1]
444857
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Within the index ED presentation
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Secondary outcome [2]
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Death
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Assessment method [2]
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As recorded in the medical recoprds
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Timepoint [2]
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At 30 days.
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Eligibility
Key inclusion criteria
• Adults greater than or equal to 18 years of age.
• A clinical cTn test is performed.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Died within ED.
• Transfers from other hospitals.
• More than 24 hours from symptom onset
• No consent
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Multiple methods will be used to determine a low-risk threshold for myocardial infarction with this assay. The point estimate of the sensitivity for this threshold must be >= 99%.
The proportion less than the low-risk threshold will be determined for efficacy.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
1/03/2025
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Date of last participant enrolment
Anticipated
31/01/2026
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Actual
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Date of last data collection
Anticipated
31/01/2027
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Actual
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Sample size
Target
2000
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Accrual to date
973
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Final
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Recruitment outside Australia
Country [1]
26772
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New Zealand
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State/province [1]
26772
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Abbott Point of Care
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Address [1]
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Country [1]
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United States of America
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Primary sponsor type
Hospital
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Name
Christchurch Hospital
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Address
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
320323
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Address [1]
320323
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Country [1]
320323
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
316651
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Southern Health and Disability Ethics Committee
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Ethics committee address [1]
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https://ethics.health.govt.nz/about/southern-health-and-disability-ethics-committee/
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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01/05/2024
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Approval date [1]
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18/06/2024
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Ethics approval number [1]
316651
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URB/06/12/093
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Summary
Brief summary
Within the emergency department doctors use a blood test called "troponin" to determine if there is any damage to the heart muscle (possible heart attack). New generation tests can determine troponin concentrations to very low levels which allow doctors to use just one test and see that some patients are not having a heart attack (and potentially could go home). The latest generation of these tests can be performed at the bedside and get results in minutes instead of hours - meaning the diagnosis can be made quicker. Each manufacturer produces slightly different troponin numbers with their test. Before such a test can be used, we must determine that it measures troponin precisely enough and we must determine the threshold concentration below which doctors can be confident that patients are not having a heart attack. This is the purpose of this study.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Martin Than
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Address
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Canterbury District Health Board and Emergency Care Foundation 21 Taylors Mistake Road Sumner Christchurch 8081
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Country
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New Zealand
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Phone
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+64 3 326 7599
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Martin Than
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Address
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Canterbury District Health Board and Emergency Care Foundation 21 Taylors Mistake Road Sumner Christchurch 8081
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Country
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New Zealand
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Phone
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+64 3 326 7599
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
138540
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Professor John Pickering
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Address
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c/- Emergency Care Foundation P O Box 13-149 Christchurch 8140
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Country
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New Zealand
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Phone
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+64 21 2537877
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Fax
138540
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Email
138540
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
No IPD sharing reason/comment:
These patients are undergoing routine clinical investigation and it is not appropriate to make the results publicly available.
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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