{"id":"d76ed9ad0e02","type":"article","url":"https://hartvaat.nl/2023/10/12/aromi-prehospitale-copeptine-versnelt-mi-uitsluiting/","title":"AROMI: prehospitale copeptine versnelt MI-uitsluiting","title_en":"Accelerated -Rule-Out of acute Myocardial Infarction using prehospital copeptin and in-hospital troponin: The AROMI study.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehad447","source_url":"https://doi.org/10.1093/eurheartj/ehad447","authors":["Claus Kjær Pedersen","Carsten Stengaard","Morten Thingemann Bøtker","Hanne Maare Søndergaard","Karen Kaae Dodt","Christian Juhl Terkelsen"],"significance":7,"published":"2023-10-12","source_date":"2023-10-12","image":"","kennis":["https://hartvaat.nl/kennis/kleplijden/mitraclip-transcatheter-mitralisreparatie/"],"congress":"","summary_en":"The AROMI study showed that prehospital copeptin measurement combined with in-hospital troponin can accelerate AMI rule-out in the ambulance setting, potentially enabling earlier triage and reducing unnecessary emergency department evaluations.","created":"2026-07-03T10:30:37Z","updated":"2026-07-03T13:29:40Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De AROMI-studie toonde dat prehospitale copeptinebepaling gecombineerd met klinisch troponine het acuut MI sneller kan uitsluiten. De strategie identificeert laagrisicopatiënten al in de ambulance, wat de SEH-doorstroom kan verbeteren.","abstract_original":"AIMS: The present acute myocardial infarction (AMI) rule-out strategies are challenged by the late temporal release of cardiac troponin. Copeptin is a non-specific biomarker of endogenous stress and rises early in AMI, covering the early period where troponin is still normal. An accelerated dual-marker rule-out strategy combining prehospital copeptin and in-hospital high-sensitivity troponin T could reduce length of hospital stay and thus the burden on the health care systems worldwide. The AROMI trial aimed to evaluate if the accelerated dual-marker rule-out strategy could safely reduce length of stay in patients discharged after early rule-out of AMI. METHODS AND RESULTS: Patients with suspected AMI transported to hospital by ambulance were randomized 1:1 to either accelerated rule-out using copeptin measured in a prehospital blood sample and high-sensitivity troponin T measured at arrival to hospital or to standard rule-out using a 0 h/3 h rule-out strategy. The AROMI study included 4351 patients with suspected AMI. The accelerated dual-marker rule-out strategy reduced mean length of stay by 0.9 h (95% confidence interval 0.7-1.1 h) in patients discharged after rule-out of AMI and was non-inferior regarding 30-day major adverse cardiac events when compared to standard rule-out (absolute risk difference -0.4%, 95% confidence interval -2.5 to 1.7; P-value for non-inferiority = 0.013). CONCLUSION: Accelerated dual marker rule-out of AMI, using a combination of prehospital copeptin and first in-hospital high-sensitivity troponin T, reduces length of hospital stay without increasing the rate of 30-day major adverse cardiac events as compared to using a 0 h/3 h rule-out strategy."}