Risk stratifying by ambulance nurses using the HEART score in patients with suspected non-STEMI is feasible and safe.
Bron
Verkorte titel
Aandoening
non-STEMI
myocardial infarction
hartinfarct
myocardial infarction
HEART-score
paramedics
ambulance nurses
pre-hospital
Ondersteuning
Roche Diagnostics for materials
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
The primary endpoint is the occurrence of MACE within 6 weeks of inclusion. MACE includes: myocardial infarction, PCI, CABG, death by all causes.
Achtergrond van het onderzoek
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.
Doel van het onderzoek
Risk stratifying by ambulance nurses using the HEART score in patients with suspected non-STEMI is feasible and safe.
Onderzoeksopzet
- Inclusion time
- primary endpoint 45 days follow up
- secondary endpoints 6 months follow up
Onderzoeksproduct en/of interventie
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.
Publiek
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
Wetenschappelijk
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
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
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
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
- 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
Opzet
Deelname
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