NCT04904107

Improving the Accuracy of Referrals of Patients With Chest Pain

A Multicentre Randomized Controlled Trial to Improve the accUracy of Referrals to the emerGency departmEnt of patieNts With chesT Pain by Using the Modified HEART Score in Emergency Medical Transport (URGENT 2.0)

• Status: Unknown
• Phase: N/A
• Study type: Interventional
• Enrollment: 852 (estimated)
• Sponsor: VieCuri Medical Centre · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

This is a multicenter, prospective, investigator-initiated, randomized controlled trial aiming to reduce the percentage of non-cardiac chest pain (NCCP) patients admitted to the cardiac emergency department (ED) by performing the modified HEART score by emergency medical transport (EMT) personnel.

Detailed description

Patients with acute coronary syndrome (ACS) should be referred to the hospital promptly. However, referring all patients with chest pain is not feasible, as recent studies showed that up to 80% of the patients with acute chest pain do not have ACS. Bedside point-of-care (POC) high sensitive troponin testing (in fingerprick blood/capillary blood) and the modified HEART score have become available and might play a substantial role in the triage and diagnosis of chest pain patients in a pre-hospital setting by general practitioners (GPs) and EMT personnel in the future. We hypothesize that patients with chest pain can be referred more accurately by using the modified HEART score.

Conditions

• Chest Pain
• Acute Coronary Syndrome
• Myocardial Infarction
• Myocardial Ischemia
• Heart Attack

Interventions

Type	Name	Description
DIAGNOSTIC_TEST	modified HEART score (including POC hs cTnI analysis)	The modified HEART score was developed in 2007 and has been validated to stratify the risk of short-term adverse cardiac events in patients with chest pain at the ED. Negative predictive value (NPV) of the modified HEART score for ACS as well as positive predictive value (PPV) for major adverse cardiac events (MACE) within 6 weeks after presentation is high. The modified HEART score is an acronym for history, ECG, age, risk factors and troponin at arrival.The components can be rated 0,1 or 2 points each and result in a total score between 0 and 10.
OTHER	Standard care and triage according to the local (EMT)protocol.	Standard care and triage of chest pain patients according to the local (EMT)protocol.

Timeline

• Start date: 2021-07-04
• Primary completion: 2023-06-01
• Completion: 2024-06-01
• First posted: 2021-05-27
• Last updated: 2022-06-10

Locations

2 sites across 1 country: Netherlands