150 Comparing the length of stay, efficacy and safety of a new 1 hour "rule-out" pathway to standard care for patients presenting to the emergency departments with a suspected acute coronary syndrome at brighton and sussex university hospitals nhs trust

Buttinger, Nicolas; White, Daniel; Shurlock, Jonathan; Blows, Lucy; Dooley, Maureen

doi:10.1136/heartjnl-2019-bcs.147

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is especially true since most emergency physicians used 3-h troponin algorithm at the time of the study. The use of approved 1-h algorithm is likely to improve LOS [25].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of HEAR score to rule-out major adverse cardiac events without troponin test in patients presenting to the emergency department with chest pain

Moumneh

Penaloza

Cismas

et al. 2021

European Journal of Emergency Medicine

View full text Add to dashboard Cite

Background and importanceCurrent guidelines for patients presenting to the emergency department with chest pain without ST-segment elevation myocardial infarction (non-STEMI) on electrocardiogram are based on troponin measurement. The HEART score is reportedly a reliable work-up strategy that combines clinical evaluation with troponin value. A clinical rule that could select very low-risk patients without the need for a blood test (HEAR score, being the HEART score without the troponin item) would be of great interest.Objectives To prospectively assess the safety of a HEAR score <2 to rule-out non-STEMI without troponin measurement. Secondary objective was to assess the safety of a sequential strategy that combines HEAR score and HEART (defined as two-step HEART strategy). Design, settings and participantsProspective observational study in six emergency departments. Patients with nontraumatic chest pain and no alternative diagnosis were included and followed up for 45 day. Patients were considered at low-risk if the HEAR score was <2 or, for the two-step HEART strategy, if the HEART score was <4. Outcomes measure and analysisThe primary endpoint was the 45-day rate of major adverse cardiac events (MACE) in patients with a HEAR score <2. A HEAR score based strategy was consider safe if the rate of the primary endpoint was below 1%, with an upper margin of the 95% confidence interval (CI) below 3%. ResultsAmong 1452 patients included, 1402 were analyzed and 97 (7%) had a MACE during the follow-up period. The HEAR score was <2 in 279 (20%) patients and one presented a MACE [0.4% (95% CI: 0.01-1.98)]. The two-step HEART strategy classified low-risk an additional 476 patients (34%) and one of these 476 patients had a MACE [0.3% (95% CI: 0.03-0.95)]. The two-step HEART strategy would have theoretically avoided 360 troponin measurements (19%). ConclusionsIn our prospective multicenter study, a HEAR based work-up strategy was safe, with a very low risk of MACE at 45 day. We also report that a twostep HEART-based strategy may safely allow significant reduction of troponin measurements in patients presenting to the emergency department with chest pain. European

show abstract

“…This is especially true since most emergency physicians used 3-h troponin algorithm at the time of the study. The use of approved 1-h algorithm is likely to improve LOS [25].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of HEAR score to rule-out major adverse cardiac events without troponin test in patients presenting to the emergency department with chest pain

Moumneh

Penaloza

Cismas

et al. 2021

European Journal of Emergency Medicine

View full text Add to dashboard Cite

show abstract

150 Comparing the length of stay, efficacy and safety of a new 1 hour "rule-out" pathway to standard care for patients presenting to the emergency departments with a suspected acute coronary syndrome at brighton and sussex university hospitals nhs trust

Abstract: Platelet aggregation results, expressed as VN ARU were divided into tertiles:. T1 (ARU 363-405) (n = 76),. T2 (ARU 406-436) (n = 76),. T3 (ARU 437-596) (n = 72).

Cited by 1 publication

References 0 publications

Evaluation of HEAR score to rule-out major adverse cardiac events without troponin test in patients presenting to the emergency department with chest pain

Evaluation of HEAR score to rule-out major adverse cardiac events without troponin test in patients presenting to the emergency department with chest pain

Contact Info

Product

Resources

About