myocardial infarction
Conditions
Interventions
None listed
Sponsors
Kyoto university
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1) Age: =>25 year old 2) Symptoms suggesting myocardial infarction 1. chest pain 2. non-chest pain A. radiation pain B. syncope C. dyspnea D. nausea E. fatigue F. symptoms which emergency physician judges to rule out myocardial infarction 3) Symptom onset is within 6 hours 4) No ST elevation at presentation 5) Emergency physician judges to take both ECG and troponin to rule out myocardial infarction
Exclusion criteria
Exclusion criteria: Satisfies any of the below 1) Cardiopulmonary arrest on arrival 2) Non-cardiac terminal illness 3) Shock status 4) Indication of immediate coronary angiography 5) Inability to obtain informed consent 6) History of severe trauma 7) Past registration for this study 8) Inability of telephone follow up 9) Unknown onset time 10) Judged as inappropriate by a board certified emergency physician 11) Respiratory failure 12) Apparent need to admit for a diagnosis other than ACS 13) Patients on maintenance dialysis
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcomes are the diagnostic accuracy of three non-structured models for composite of myocardial infarction and death within 30 days. The measures of accuracy are; negative predictive value; sensitivity; percentages of patients eligible for rule-out of myocardial infarction. The non-structured models are comprised of three elements and judged as positive if at least one of the elements is positive. 3 non-structured models are below. *Model 1 1: history and physical findings are high risk 2: presence of new ischemic changes of ECG 3: troponin on arrival is positive *Model2 1: history and physical findings are high risk 2: presence of new ischemic changes of ECG 3: troponin on arrival and/or after one hour is positive *Model 3 1: history and physical findings are high risk 2: presence of new ischemic changes of ECG 3: troponin on arrival and/or after 2 hours is positive | — |
Secondary
| Measure | Time frame |
|---|---|
| *Secondary outcome 1 Comparison of the diagnostic accuracy of non-structured models and structured models *Secondary outcome 2 We separate patients by some factors, such as onset to arrival time; presence or absence of chest pain; past history of myocardial infarction; past history of coronary artery disease. *Secondary outcome 3 Reliabilities of the risk estimation of history and physical findings in a non-structured way; each component of history and physical findings; ECG. | — |
Countries
Japan
Contacts
Public ContactMasafumi Tada
Kyoto university graduate school of medicine Department of health promotion and human behavior
Outcome results
None listed