Can a new Emergency Department Assessment of Chest-pain Score (EDACS) reduce hospital admissions and observation for patients presenting with possible heart attack?

Not Applicable

Recruiting

• Conditions: Cardiac Chest Pain; Cardiovascular - Coronary heart disease; Public Health - Health service research

• Registration Number: ACTRN12613000745741
• Lead Sponsor: ew Zealand Health Research Council

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2013-07-04
• Last Update Posted: 13 January 2020

Recruitment & Eligibility

• Status: Recruiting
• Sex: All
• Target Recruitment: 530

Inclusion Criteria

Adults (age 18 years or older) presenting acutely from the community to the Emergency Department (ED) with chest pain suggestive of acute coronary syndrome for whom, the attending clinician(s) intend(s) to perform serial troponin analysis (cTns), to investigate for possible acute myocardial infarction.

In accordance with American Heart Association guidelines, possible cardiac symptoms include: the presence of acute chest, epigastric, neck, jaw or arm pain or discomfort or pressure without apparent non-cardiac source.

Exclusion Criteria

ST Segment Elevation Myocardial Infarction (STEMI) present on any electrocardiograph (ECG). (These patients are at very high risk and guidelines mandate immediate transfer to cardiology facilities for treatment and/ monitoring)

Patients with proven or suspected non-coronary pathology as the cause of chest pain

Patients who will require admission regardless of a negative cTn, due to other medical conditions, or need for other investigations

Transfers from other departments or hospitals and patients attending with an acute troponin result already known to be raised before arrival.

Subjects previously enrolled in this study

Anticipated problem with follow-up e.g. resident outside New Zealand
Patient (or Legal Representative) unable or unwilling to provide informed consent

Patients for whom the researcher does not think that recruitment is appropriate for non-medical reasons (e.g. poor mental status, emotionally vulnerable)

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Primary objective: Compare the effectiveness, when applied to clinical practice, of an accelerated diagnostic protocol within a clinical pathway that uses the EDACS score against the standard accelerated diagnostic process at Christchurch Hospital which incorporates the Thrombolysis In Myocardial Infarction (TIMI) score.[The proportion of patients successfully discharged home after ED assessment within 6 hours of ED arrival with no Major Adverse Cardiac Event (MACE) during the following 30 days. ]