Pre-hospital evaluation of chest pain patients using the modified HEART-score: rationale and design.
Jaouad AzzahhafiDean R P P Chan Pin YinMirjam EppingHajar BofaridSem A O F RikkenThijs VerhagenRene BoomarsAnja RadstokJaco HoutgraafAngela BikkerJurrien M Ten BergPublished in: Future cardiology (2024)
Background: This study assesses how ambulance paramedics using the modified HEART-score with a point-of-care cardiac troponin (cTn) compare to the emergency physicians using the modified HEART-score with a high-sensitive cTn (hs-cTn) in patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS), focusing on interobserver agreement and diagnostic performance. Methods: In this prospective multicenter cohort, we compare four cTn testing strategies (serial point of care and hs-cTn cTn measurement) with and without the HEART-score. Outcomes include the HEART-score's interobserver agreement, NSTE-ACS at discharge, major adverse cardiovascular events (MACE) after 30 days, and diagnostic accuracy of the different strategies. Conclusion: The POPular HEART study aims to improve NSTE-ACS diagnostic pathways, promoting pre-hospital detection and ruling out of NSTE-ACS to minimize unnecessary hospitalizations and associated costs. Clinical Trial Registration: NCT04851418 (ClinicalTrials.gov).
Keyphrases
- acute coronary syndrome
- heart failure
- cardiovascular events
- clinical trial
- atrial fibrillation
- percutaneous coronary intervention
- healthcare
- antiplatelet therapy
- emergency department
- coronary artery disease
- ejection fraction
- cardiovascular disease
- public health
- newly diagnosed
- type diabetes
- acute care
- adverse drug
- adipose tissue
- chronic kidney disease
- patient reported outcomes
- insulin resistance
- real time pcr