Pre-hospital evaluation of chest pain patients using the modified HEART-score: rationale and design.

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Future cardiology Pub Date : 2024-04-25 Epub Date: 2024-06-28 DOI:10.1080/14796678.2024.2356995

Jaouad Azzahhafi, Dean Rpp Chan Pin Yin, Mirjam Epping, Hajar Bofarid, Sem Aof Rikken, Thijs Verhagen, Rene Boomars, Anja Radstok, Jaco Houtgraaf, Angela Bikker, Jurriën M Ten Berg

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Abstract

Background: This study assesses how ambulance paramedics using the modified HEART-score with a point-of-care cardiac troponin (cTn) compare to the emergency physicians using the modified HEART-score with a high-sensitive cTn (hs-cTn) in patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS), focusing on interobserver agreement and diagnostic performance. Methods: In this prospective multicenter cohort, we compare four cTn testing strategies (serial point of care and hs-cTn cTn measurement) with and without the HEART-score. Outcomes include the HEART-score's interobserver agreement, NSTE-ACS at discharge, major adverse cardiovascular events (MACE) after 30 days, and diagnostic accuracy of the different strategies. Conclusion: The POPular HEART study aims to improve NSTE-ACS diagnostic pathways, promoting pre-hospital detection and ruling out of NSTE-ACS to minimize unnecessary hospitalizations and associated costs.Clinical Trial Registration: NCT04851418 (ClinicalTrials.gov).

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使用改良 HEART 评分对胸痛患者进行院前评估：原理与设计。

背景：本研究评估了救护车护理人员与急诊科医生在疑似非 STE-ACS 患者中使用改良 HEART 评分和床旁心肌肌钙蛋白（cTn）的情况，重点是观察者之间的一致性和诊断效果。方法：在这一前瞻性多中心队列中，我们比较了使用和不使用 HEART-score 的四种 cTn 检测策略（序列护理点和 hs-cTn cTn 测量）。结果包括 HEART 评分的观察者间一致性、出院时的 NSTE-ACS、30 天后的主要不良心血管事件 (MACE) 以及不同策略的诊断准确性。结论POPular HEART 研究旨在改善 NSTE-ACS 诊断路径，促进院前检测和排除 NSTE-ACS 以减少不必要的住院治疗和相关费用：临床试验注册：NCT04851418（ClinicalTrials.gov）。

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来源期刊

Future cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.80

自引率

5.90%

发文量

期刊介绍： Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.