Providing Rapid Out of Hospital Acute Cardiovascular Treatment (PROACT) Novel Proximal Pathways for Non ST Elevation Myocardial Infarction
Overview
- Phase
- Phase 4
- Intervention
- Not specified
- Conditions
- NSTEMI
- Sponsor
- University of Alberta
- Enrollment
- 601
- Locations
- 5
- Primary Endpoint
- Time from first medical contact to final patient disposition.
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
The purpose of this study is to determine if early diagnosis and risk stratification acquired through pre-hospital clinical assessment, 12-lead electrocardiogram and point of care biomarkers will facilitate enhanced triage and treatment in patients with presumed non-ST elevation acute coronary syndromes (NSTEMI).
Detailed Description
Utilizing the platform of pre-hospital STEMI research and clinical experience developed over the past decade; we now intend to investigate how best to achieve timely diagnosis and risk stratification of patients that present to pre-hospital emergency medical services with symptoms suspicious for acute NSTEMI through utilization of systematic clinical assessment, pre-hospital 12 lead electrocardiogram and point of care measurement of biomarkers. Additionally, where deemed appropriate these patients will be enrolled in a clinical Chest Pain Protocol utilizing the pre-hospital biomarkers. We hypothesize that establishing a pre-hospital diagnosis in this condition may facilitate efficient triage and -as appropriate- in-hospital disposition. Additionally, the enhanced pre-hospital assessment of this population will facilitate appropriate timely disposition of those patients not found to have acute cardiovascular disease. These processes will facilitate decanting the frequently overcrowded and under resources Emergency Departments.
Investigators
Robert Welsh
Principal Investigator
University of Alberta
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Time from first medical contact to final patient disposition.
Time Frame: From date of first medical contact until first appropriate therapy given, assessed up to 30 months
An Adjudication Committee will examine the records to determine final diagnosis. Final patient disposition is defined as the time when a plan for patient discharge from the ED or admission to hospital is both established and documented.
Secondary Outcomes
- Time to administration of appropriate evidence based therapy(Assessed up to 30 months.)
- Length of hospital stay for patients admitted to hospital(Assessed up to 30 months)
- In-hospital clinical events (day 7 or discharge) all-cause mortality, cardiogenic shock, heart failure, re-Myocardial infarction(Assessed up to 30 months)
- 30-day all-cause mortality(Assessed up to 30 months)
- 30 day all-cause hospitalization or re-hospitalization(Assessed up to 30 months)
- 30-day composite (all-cause mortality or all-cause hospitalization)(Assessed up to 30 months)