Acute Aortic Dissection, Acute Coronary Syndrome, Acute Myocardial Infarction Type 1, Chest Pain, Pulmonary Embolism
Conditions
Keywords
Chest pain, Acute Aortic Dissection, Pulmonary Embolism, Acute Coronary Syndrome, Acute myocardial infarction, Risk stratification, Prognosis, Biomarkers
Brief summary
In this study, clinical database and blood sample bank of acute chest pain (ACP) will be established at chest pain center of multi-center hospital. To explore new biomarkers and screen clinical indicators with effective risk stratification and prognostic evaluation for ACP through proteomics technology and statistics methods. Risk stratification and short-term and long-term prognostic evaluation models for high-risk ACP will be established using large data analysis.
Detailed description
In this study, acute chest pain (ACP) patients will be selected from chest pain center of nine large tertiary hospitals in China from November 1, 2019 to October 31, 2021. All the selected patients will sign the informed consent. Patients' characteristics, the first vital signs at the time of consultation, the first arterial blood gas, complete blood count, coagulation markers, blood biochemical results and myocardial injury markers, imaging examinations and electrocardiogram will be collected within 30 minutes at admission. Meanwhile, whole blood and plasma samples will be collected and stored in - 80 ℃ refrigerator. After diagnosis according to the gold standard examination or related guidelines, patients will be admitted to different department for standard treatment. Medication, surgical procedures and complications will be recorded carefully. Plasma and whole blood will be used to detect proteomics and/or genomics biomarkers associated with early evaluation of ACP. Screening early evaluation indicators using novel protein biomarkers and easy-to-obtain clinical indicators, and establishing evaluation models for high-risk ACP by data analysis methods. Area under the receiver operating characteristic curves (AUROC), net reclassification improvement (NRI), integrated discrimination improvement (IDI) and decision curve analysis (DCA) will be used to evaluate the prediction ability of the model.
Interventions
DIAGNOSTIC_TESTCoronary angiography
Acute chest pain patients, suspected acute coronary syndrome, are diagnosed by coronary angiography.
DIAGNOSTIC_TESTCT angiography of aorta
Acute chest pain patients, suspected acute aortic dissection, are diagnosed by gold standard of CTA.
DIAGNOSTIC_TESTCT angiography of pulmonary arteries.
Acute chest pain patients, suspected acute pulmonary embolism, are diagnosed by gold standard of CTA.
DIAGNOSTIC_TESTElectrocardiogram
All patients with acute chest pain will subject to ECG examination within 10 minutes of admission, which can quickly screen ST-segment elevation myocardial infarction.
DIAGNOSTIC_TESTCardiac Troponin
Dynamic changes of cardiac troponin I and/or T will be used in the diagnosis of acute myocardial infarction
Sponsors
West China Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
Yes
Inclusion criteria
* Patient aged 18-90 years old; * The time from onset of symptoms to emergency room is less than 24 hours.
Exclusion criteria
* Patients complicate with end-stage neoplastic diseases; * Pregnant women; * Patients re-visit during the selection period; * Patients refuse to participate in this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of participants with acute aortic dissection | Twenty-four hours | Chest pain patients are diagnosed as acute aortic dissection based on CT of aortic angiography. |
| Rate of participants with acute coronary syndrome | Twenty-four hours | Chest pain patients are diagnosed as acute coronary syndrome based on European Society of Cardiology (ESC) guidelines. |
| Rate of participants with all-cause death | One year | Patients die of all causes during hospitalization or follow-up |
| Rate of participants with cardiovascular death | One year | Patients die of cardiac and cerebrovascular diseases during hospitalization or follow-up |
| Rate of participants with major adverse cardiac events (MACEs) | One year | MACEs include cardiac death, stroke, and recurrent myocardial infarction. |
| Rate of participants with acute myocardial infarction | Twenty-four hours | Chest pain patients are diagnosed as acute myocardial infarction based on fourth edition of guidelines for myocardial infarction |
| Rate of participants with acute pulmonary embolism | Twenty-four hours | Chest pain patients are diagnosed as acute pulmonary embolism based on CT of pulmonary angiography. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of participants with malignant arrhythmia | Two weeks | Patients complicate with malignant arrhythmia during hospitalization |
| Rate of participants with pericardial tamponade | Two weeks | Patients complicate with pericardial tamponade during hospitalization |
| Rate of participants with multiple organ dysfunction syndrome | Two weeks | Patients complicate with multiple organ dysfunction syndrome during hospitalization |
| Rate of participants with respiratory failure | Two weeks | Patients complicate with respiratory failure during hospitalization |
| Rate of participants with cardiac arrest | Two weeks | The sudden termination of cardiac ejection function, the disappearance of great artery pulsation and heart sound, and severe ischemia and hypoxia of important organs (such as brain) lead to the termination of life. |
| Rate of participants with bleeding | One year | Patients complicate with bleeding |
| Rate of participants with acute kidney injury | Two weeks | Patients complicate with acute kidney injury during hospitalization |
| Rate of participants with revascularization | Two weeks | Patients receive revascularization for recurrent angina or myocardial infarction during hospitalization |
| Rate of participants with consciousness disorder | Two weeks | Patients complicate with consciousness disorder during hospitalization |
| Rate of participants with cardiogenic shock | Two weeks | Patients complicate with cardiogenic shock during hospitalization |
| Rate of participants with ischemia or necrosis of lower limbs | Two weeks | Patients complicate with ischemia or necrosis of lower limbs during hospitalization |
| Rate of participants with acute heart failure | Two weeks | Patients complicate with acute heart failure during hospitalization |
Other
| Measure | Time frame | Description |
|---|---|---|
| Length of stay | Two weeks | Time between patient's visit and discharge |
| Rate of re-admitted participants | Six months | Re-admission after discharge within 6 months |
Countries
China
Contacts
Primary ContactDongze Li, MBBS
Backup ContactYisong Cheng, MBBS
Outcome results
None listed