No registrations found.
Source
Brief title
Health condition
non-STEMI
myocardial infarction
hartinfarct
myocardial infarction
HEART-score
paramedics
ambulance nurses
pre-hospital
Sponsors and support
Roche Diagnostics for materials
Intervention
Outcome measures
Primary outcome
The primary endpoint is the occurrence of MACE within 6 weeks of inclusion. MACE includes: myocardial infarction, PCI, CABG, death by all causes.
Secondary outcome
Secondary outcomes are the occurrence of MACE within 6 months of inclusion, the number of patients that are secondarily referred to the hospital for cardiac reasons with a HEART score of ≤3 within 6 months after inclusion, discharge diagnosis of all patient primarily or secondarily referred to the hospital within 6 months after inclusion, health care costs, the number of inter-hospital transfers between PCI and non-PCI centres, length of hospital stay, performed diagnostics, cause of death, differences in patient characteristics between the low, intermediate and high risk groups, quality of life.
Background summary
Chest pain suspected for non-ST segment elevation (non-STEMI) is a diagnostic challenge for health care providers since there is a wide variety in causes. Earlier management is possible when differentiation between low- and high risk patients is performed prehospital by paramedics. The HEART score proved to be a feasible and adequate tool to achieve this. So far all pre-hospital HEART studies have been observational. We set out to quantify the impact of the implementation of the pre-hospital HEART score in daily practice.
Study objective
Risk stratifying by ambulance nurses using the HEART score in patients with suspected non-STEMI is feasible and safe.
Study design
- Inclusion time
- primary endpoint 45 days follow up
- secondary endpoints 6 months follow up
Intervention
pre-hospital HEART assessment including POC troponin. Patients with low risk (HEART-score 3 or lower) will be asked for informed consent to be observed at home. A second HEART score will be performed by paramedics after 3-12 hours.
Patients at intermediate or high risk (HEART-score 4 or higher) will be transfered to a hospital and asked for informed consent for dossier study and contact for study questions when needed.
Department of Cardiology,
Groot Wezenland 20
J.P. Ottervanger
Groot Wezenland 20
Zwolle 8011 JW
The Netherlands
+31 (0)38 4242374 / +31 (0)38 4242000
Department of Cardiology,
Groot Wezenland 20
J.P. Ottervanger
Groot Wezenland 20
Zwolle 8011 JW
The Netherlands
+31 (0)38 4242374 / +31 (0)38 4242000
Inclusion criteria
All out-of-hospital patients visited by an ambulance with a pre-hospital suspicion of non-STEMI ACS at first medical contact
Age ≥ 18 years
Exclusion criteria
- Comatose state
- Cognitive impairment
- Pregnancy
- Shock
- Cardiac asthma
- Sustained ventricular tachyarrhythmia
- Electrocardiographic ST-segment elevation
- Endstage renal disease
- No pre-hospital 12-lead ECG performed or available
- An obvious non-cardiac cause for chest complaints (trauma, pneumothorax, pneumonia, etc.)
- Strong suspicion of aortic dissection or pulmonary embolism
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
NTR-new | NL6833 |
NTR-old | NTR7070 |
Other | METC Zwolle : 170526 |