Reducing unnecessary admissions for chest pain with the Manchester Acute Coronary Syndromes (MACS) decision rule

Reducing unnecessary admissions for chest pain with the Manchester Acute Coronary Syndromes (MACS) decision rule: feasibility study

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

ISRCTN

Registry ID

ISRCTN86818215

Enrollment

100

Registered

2013-06-12

Start date

2013-08-01

Completion date

Unknown

Last updated

2017-07-03

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

Conditions

Topic: Cardiovascular, Injuries and Emergencies

Interventions

1. Control Group: Care of the control group will be guided by local Emergency Department guidelines for the management of suspected cardiac chest pain, which are compliant with current national and in

Study Entry : Single Randomisation only

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: Consenting patients, over 18 years of age, presenting to the ED with pain, discomfort or pressure in the chest, epigastrium, neck, jaw, or upper limb without an apparent non-cardiac source (compatible with the American Heart Association case definitions), which the treating physician believes warrants investigation for a possible acute coronary syndrome. Target Gender: Male & Female; Upper Age Limit 150 years ; Lower Age Limit 18 years

Exclusion criteria

Exclusion criteria: 1. Peak symptoms occurred more than 24 hours prior to presentation 2. Another medical condition necessitating hospital admission 3. Definite ST elevation myocardial infarction needing immediate revasularisation 4. No capacity to provide informed consent 5. Inability to communicate in English language if translation services are unavailable 6. Prisoners

Design outcomes

Primary

Measure	Time frame
Successful early discharge, defined as a decision to discharge from the ED within 4 hours of arrival; Timepoint(s): Assessed once (can be assessed from 30 days after randomisation) (Primary clinical outcome).	—

Secondary

Measure	Time frame
1. Acceptability of trial processes to clinicians and patients; Timepoint(s): Within 30 days of randomisation (feasibility outcome) 2. Attrition (including both failure to complete the trial protocol and loss to follow up); Timepoint(s): Assessed once, on study completion (feasibility outcome) 3. Completeness of data collection; Timepoint(s): Assessed once, on study completion (feasibility outcome) 4. Direct healthcare costs; Timepoint(s): 30 days, 3 months, 6 months 5. Health status (EQ-5D); Timepoint(s): 30 days, 3 months, 6 months 6. Length of initial hospital stay; Timepoint(s): Assessed once, on study completion (clinical outcome) 7. Major adverse cardiac events (death, coronary revascularisation, acute myocardial infarction); Timepoint(s): 30 days, 3 months, 6 months 8. Patient satisfaction; Timepoint(s): 30 days and 6 months 9. Reasons for lack of compliance with the trial protocol; Timepoint(s): Within 30 days of randomisation (feasibility outcome) 10. The number of eligible patients; Timepoint(s): Assessed once, upon study completion (feasibility outcome) 11. The proportion of eligible patients randomised; Timepoint(s): Assessed once, on study completion (feasibility outcome)	—

Measure

Time frame

1. Acceptability of trial processes to clinicians and patients; Timepoint(s): Within 30 days of randomisation (feasibility outcome) 2. Attrition (including both failure to complete the trial protocol and loss to follow up); Timepoint(s): Assessed once, on study completion (feasibility outcome) 3. Completeness of data collection; Timepoint(s): Assessed once, on study completion (feasibility outcome) 4. Direct healthcare costs; Timepoint(s): 30 days, 3 months, 6 months 5. Health status (EQ-5D); Timepoint(s): 30 days, 3 months, 6 months 6. Length of initial hospital stay; Timepoint(s): Assessed once, on study completion (clinical outcome) 7. Major adverse cardiac events (death, coronary revascularisation, acute myocardial infarction); Timepoint(s): 30 days, 3 months, 6 months 8. Patient satisfaction; Timepoint(s): 30 days and 6 months 9. Reasons for lack of compliance with the trial protocol; Timepoint(s): Within 30 days of randomisation (feasibility outcome) 10. The number of eligible patients; Timepoint(s): Assessed once, upon study completion (feasibility outcome) 11. The proportion of eligible patients randomised; Timepoint(s): Assessed once, on study completion (feasibility outcome)

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Countries

United Kingdom

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Feb 4, 2026