None listed
Conditions
Brief summary
The aim of this study is to prospectively investigate the accuracy and safety of an accelerated chest pain diagnostic pathway in patients presenting with intermediate risk chest pain in an Australian setting. The primary objective is to demonstrate the sensitivity, specificity and predictive values of the rule for ACS-related diagnoses at 30 days post discharge. The secondary objective is to demonstrate the sensitivity, specificity and predictive values of the rule for the composite oucome of patients who are admitted to hospital for potential ACS. That is, those with an ACS related diagnosis or significant exercise stress test (EST) findings (positive or indeterminate results).
Interventions
Patients presenting to the Emergency Department will be assessed using a newly developed risk stratification process for acute coronary syndrome.
Patients will be deemed HIGH risk according to the high risk criteria of the National Heart Foundation/CS-ANZ guidelines 2006. Patients will be deemed VERY LOW risk if: Age <40, no history of DM, no renal impairment, normal (<= 0.04mcg/L) initial troponin and normal ECG. All others are INTERMEDIATE risk. This risk stratification will be applied in the
Patients presenting to the Emergency Department will be assessed using a newly developed risk stratification process for acute coronary syndrome. Patients will be deemed HIGH risk according to the high risk criteria of the National Heart Foundation/CS-ANZ guidelines 2006. Patients will be deemed VERY LOW risk if: Age <40, no history of DM, no renal impairment, normal (<= 0.04mcg/L) initial troponin and normal ECG. All others are INTERMEDIATE risk. This risk stratification will be applied in the Emergency Department on presentation, with ECG and troponin results available. This intervention is administered for the period of the index presentation.
Sponsors
Investigator initiated study - Dr Louise Cullen, Senior Staff Specialist
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patient with symptoms of greater than or equal to 5 minutes consistent with possible ACS (chest discomfort or angina equivalent) AND/OR Physician plans to evaluate the patient for potential ACS AND Intermediate risk features on QLD CPP
Exclusion criteria
More than 2 hours since arrival at hopsital. Patient (or Legal Representative) is unable or unwilling to provide informed consent. Transfer from other hosptial. Patient (or Legal Representative) refusal of telephone follow-up or medical record review at 30 days or unlikely to be contactable for follow-up. Reasearcher does not feel that informed consent is obtainable or that recruitment is apporpriate (e.g. terminal illness). Pregnant. Clear alternative non-ACS diagnostic cause for symptoms. High risk features according to QLD CPP.
Outcome results
None listed