Pincombe, Aubyn and Gray, Jodi and Hickling, Siobhan and Sanfilippo, Frank and Briffa, Tom and Cullen, Louise and Chew, Derek and Hillis, Graham and Fatovich, Daniel and Rankin, Jamie and Nedkoff, Lee and Scanlan, Samuel and Hickman, Peter E. and Stapleton, Stuart and Parsonage, William and Mitra, Biswadev and Schneider, Hans G. and Wilkes, Garry and Robinson, Teagan and Karnon, Jonathan (2025) Cost-effectiveness of the transition from conventional to high-sensitivity troponin assay for the investigation and management of suspected acute coronary syndrome in the emergency department. American Heart Journal, 287. pp.107-118. ISSN 00028703
Full text not available from this repository.Abstract
BACKGROUND: Switching from conventional to high-sensitivity cardiac troponin (hs-cTn) assays with sex-specific reference rates for threshold troponin levels enables detection of smaller amounts of myocardial damage. However, the real-world impact of these assays on patient outcomes and health service costs is poorly understood. We investigated the cost-effectiveness of switching to hs-cTn assays for patients presenting to Australian Emergency Departments (EDs) with suspected acute coronary syndrome (ACS) with a 12-month follow-up period. METHODS: Using linked administrative data from 9 tertiary hospitals for patients aged 20 and above who presented to ED with suspected ACS between March 2011 and November 2015, we applied a difference-in-differences methodology to compare costs and major adverse cardiac events between hospitals switching to hs-cTn assays and hospitals continuing to use conventional assays. RESULTS: We identified 179,681 consecutive patients, of whom 87,019 presented during the preperiod and 92,662 the postperiod. Switching to hs-cTn was associated with a reduction in the cost of the index event (-$1,022, 95% CI: -$1,034, -$1,009), a reduction in total costs at 12 months (-$1,373, 95% CI: -$1,387, -$1,360) and a reduction in the percentage of patients experiencing a MACE outcome within 12-months (-0.55%, 95% CI: -0.88%, -0.21%). The reduction in MACE outcomes was larger for female patients (-1.17%, 95% CI: -1.19%, -1.14%) than for all patients and for males. CONCLUSIONS: The switch to hs-cTn is highly cost-effective across all patients and for each sex. The reduction in MACE outcomes and costs within 12 months are greater for females than for males.
| Item Type: | Article |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Depositing User: | Repository Administrator |
| Date Deposited: | 31 Oct 2025 04:50 |
| Last Modified: | 31 Oct 2025 04:50 |
| URI: | http://eprints.victorchang.edu.au/id/eprint/1721 |
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