TY - JOUR
T1 - Fast assessment and management of chest pain patients without ST-elevation in the pre-hospital gateway (FamouS Triage)
T2 - ruling out a myocardial infarction at home with the modified HEART score
AU - Ishak, Maycel
AU - Ali, Danish
AU - Fokkert, Marion J.
AU - Slingerland, Robbert J.
AU - Tolsma, Rudolf T.
AU - Badings, Erik
AU - van der Sluis, Aize
AU - van Eenennaam, Fred
AU - Mosterd, Arend
AU - Ten Berg, Jurriën M.
AU - van 't Hof, Arnoud Wj
N1 - Publisher Copyright:
© 2017, © The European Society of Cardiology 2017.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - BACKGROUND: The first study of the FamouS Triage project investigates the feasibility of ruling out a myocardial infarction in pre-hospital chest pain patients without electrocardiographic ST-segment elevation by using the modified HEART score at the patient's home, incorporating only a single highly sensitive troponin T measurement.METHODS: A venous blood sample was drawn in the ambulance from 1127 consecutive chest pain patients for measurement of the pre-hospital highly sensitive troponin T levels, in order to establish a pre-hospital HEART score (i.e. the modified HEART score) and evaluate the possibility of triage at the patient's home. The primary endpoint was the occurrence of a major adverse cardiac event (MACE) i.e. acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting or death within 30 days after initial presentation.RESULTS: Two hundred and six patients (18%) developed a MACE during 30 days of follow-up. Thirty-six per cent of the patients ( n=403) had a low modified HEART score (0-3 points) and none of them developed a MACE during follow-up. Forty-four per cent of the patients ( n=494) had an intermediate modified HEART score (4-6 points) and 18% of them developed a MACE. Twenty per cent of the patients ( n=230) had a high modified HEART score (7-10 points) of which 52% developed a MACE during follow-up.CONCLUSION: It seems feasible to rule out a myocardial infarction at home in chest pain patients without ST-segment elevation by using the modified HEART score.TRIAL ID: NTR4205. Dutch Trial Register [ http://www.trialregister.nl ]: trial number 4205.
AB - BACKGROUND: The first study of the FamouS Triage project investigates the feasibility of ruling out a myocardial infarction in pre-hospital chest pain patients without electrocardiographic ST-segment elevation by using the modified HEART score at the patient's home, incorporating only a single highly sensitive troponin T measurement.METHODS: A venous blood sample was drawn in the ambulance from 1127 consecutive chest pain patients for measurement of the pre-hospital highly sensitive troponin T levels, in order to establish a pre-hospital HEART score (i.e. the modified HEART score) and evaluate the possibility of triage at the patient's home. The primary endpoint was the occurrence of a major adverse cardiac event (MACE) i.e. acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting or death within 30 days after initial presentation.RESULTS: Two hundred and six patients (18%) developed a MACE during 30 days of follow-up. Thirty-six per cent of the patients ( n=403) had a low modified HEART score (0-3 points) and none of them developed a MACE during follow-up. Forty-four per cent of the patients ( n=494) had an intermediate modified HEART score (4-6 points) and 18% of them developed a MACE. Twenty per cent of the patients ( n=230) had a high modified HEART score (7-10 points) of which 52% developed a MACE during follow-up.CONCLUSION: It seems feasible to rule out a myocardial infarction at home in chest pain patients without ST-segment elevation by using the modified HEART score.TRIAL ID: NTR4205. Dutch Trial Register [ http://www.trialregister.nl ]: trial number 4205.
KW - acute myocardial infarction
KW - chest pain
KW - highly sensitive troponin
KW - modified HEART score
KW - non-ST-segment elevation acute coronary syndrome
KW - Pre-hospital triage
UR - http://www.scopus.com/inward/record.url?scp=85018431722&partnerID=8YFLogxK
U2 - 10.1177/2048872616687116
DO - 10.1177/2048872616687116
M3 - Article
C2 - 28084079
AN - SCOPUS:85018431722
SN - 2048-8734
VL - 7
SP - 102
EP - 110
JO - European heart journal. Acute cardiovascular care
JF - European heart journal. Acute cardiovascular care
IS - 2
ER -