Chest Pain
Conditions
Keywords
copeptin, troponin HS
Brief summary
The main objective of our study is to evaluate the diagnostic value of copeptin testing in association with troponin HS testing during pre-hospital care (ambulance care) in the treatment of patients whose pattern of use is the occurrence chest pain suggestive of ACS but not ST+.
Detailed description
The secondary objectives of this study are to: A. Evaluate the diagnostic value of determination of copeptin testing in pre-hospital care in another diagnosis; B. Assess the prognostic value of copeptin assay on vital prognosis at day 28; C. Evaluate the kinetics of copeptin and troponin HS between initial ambulance care and arrival at the emergency department; D. Evaluate the potential impact of copeptin testing on pre-hospital patient care; E. Assess the economic impact of pre-hospital copeptin testing in terms of hospital stays and optimizing ambulance movements.
Interventions
BIOLOGICALBlood work in the ambulance
Blood sample for copeptin and troponin HS testing is taken during ambulance care.
BIOLOGICALBlood work upon arrival in the emergency room
Blood in drawn for copeptin and troponin HS testing upon arrival in the emergency room.
BIOLOGICALBlood work at 3 hours post-arrival in the emergency room
Blood is drawn for troponin HS testing 3 hours after the patient's arrival in the emergency room.
Sponsors
Centre Hospitalier Universitaire de Nīmes
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* all major adult patients taken in charge by the emergency ambulance services of the participating centers for non-traumatic chest pain for suspected ACS and an electrocardiogram initially excluding an ST segment elevation
Exclusion criteria
* The patient is participating in another study * The patient is in an exclusion period determined by a previous study * The patient is under judicial protection, under tutorship or curatorship * The patient (or a legal representative) formalizes his/her opposition for the study * It is impossible to correctly inform the patient * The patient is pregnant, parturient, or breastfeeding * The patient has a contraindication for a treatment used in this study * The patient's initial electrocardiogram indicates an ST segment elevation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Blood troponin HS concentration (µg/L) | Day 0, in the ambulance |
| Blood copeptin concentration (pmol/l) | Day 0, in the ambulance |
| Final diagnosis of ACS non ST + (yes/no) | Day 28 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hospital costs (€) associated with avoidable services | Day 28 | — |
| Distance (km) between the hospital and the patient's place of residence | Day 28 | — |
| Blood troponin HS concentration (µg/L) | Day 0, upon arrival in the emergency department | — |
| Presence/absence of another diagnosis | Day 28 | — |
| Number of patients taken in charge that day by ambulance staff. | Day 0 | — |
| Time spent by ambulance staff at the patient's place of residence | Day 0 | — |
| Mortality | Day 28 | — |
| Would you leave the patient at home if both copeptin and troponin tests were negative? | Day O (in the ambulance) | Yes/no question asked of ambulance doctors. |
Countries
France
Outcome results
None listed