The QUeensland Accelerated Risk Trial (QUART): Accelerated pathways in the assessment of suspected acute coronary syndrome in the Emergency Department.

In patients presenting to the emergency department with potential acute coroanry syndrome (ACS) is there a difference in the change in troponin (absolute and rate) and a traditional mulitmarker approach with risk stratification tools in excluding significant coronary artery disease?

Status

Completed

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12610000053022

Enrollment

1000

Registered

2010-01-18

Start date

2008-10-29

Completion date

2011-02-04

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

This study examines whether patients presenting to emergency with chest pain can be managed more rapidly than current standard care. The current process involves blood tests over 6-24 hours. The study study examines the safety of an ‘accelerated chest pain algorithm’ . That is whether combining the results of blood tests such as Troponin I, creatine-kinase MB fraction (CK-MB), and myoglobin over a 2 hour time period from presentation with a risk stratification process allows early futher testing or discharge of patients with potential acute coronary syndrome (ACS). These results will be used to develop a pathway for investigation of pateints with potential acute coronary syndrome (ACS) in the Emergency Department.

Interventions

This study is designed to prospectively validate that an ‘accelerated chest pain algorithm’ involving blood levels of Troponin I, creatine-kinase MB fraction (CK-MB), and myoglobin or ‘delta’ troponin measurements over a 2 hour time period from presentation with a risk stratification process allows ealry futher testing or discharge of patients with intermediate risk for acute coronary syndrome (ACS) presenting to the Emergency department (ED). These results will be used to develop a pathway for investigation of pateints with potential acute coronary syndrome (ACS). We will focus on delta troponin, as well as myoglobin, and CK-MB combinations and look at absolute change in biomarker levels and rates of change to identify the population at risk for ACS. The overall duration will be ~ 2years.

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

Inclusion criteria include all patients who present to the ED with at least 5 minutes of chest pain suggestive of ACS. In accord with American Heart Association (AHA) guidelines, these will include the presence of acute chest, epigastric, neck, jaw or arm pain or discomfort or pressure or breathlessness without apparent non-cardiac source. More general/atypical symptoms (such as fatigue, nausea, vomiting, sweating and faintness) will not be used as inclusion criteria. Patients who have chest discomfort and in whom the attending staff consider it necessary to perform an electrocardiogram (ECG) for the assessment of possible ACS will be enrolled.

Exclusion criteria

Pregnancy Patients under the age of 18 years old Unable or unwilling to consent Patients for whom follow-up will not be possible either due to lack of contact address or because they will be overseas.

Outcome results