Prognostic Accuracy of the HEART Score in Undifferentiated Chest Pain: A Multicenter Validation Study

NCT04580017 | Completed

• 1 other identifier: HEART score
• Study Type: observational
• Target: 4,267
• Locations: 1 country
• Sites: 3

Brief Summary

Chest pain remains one of the most common, potentially serious presenting complaints for adults emergency department visits with approximately 7.6 million yearly visits in the united states. The priority for emergency physician is to determine whether these patients with acute chest pain have a potential life threatening underlying etiology. The great challenge is to differentiate patients presenting with acute coronary syndrome and those with other more benign conditions. There is a global tendency for ED physician to over investigate chest pain patients , even in low-risk patients. This kind of practice leads to resource over-utilization and a huge health costs waste contrasting with no outcomes improvement. For many years, physicians have been searching tools, ranging from specific diagnostic tests to entire strategies of evaluation, to appropriately stratify the risk in patients with chest pain in order to simultaneously prevent major adverse cardiac events and reduce unnecessary testing and hospitalizations. Many bioclinical scores have been developed, such as the TIMI score and the GRACE score.The HEART score is one of the more recently proposed model derived through a process involving expert opinion and review of medical literature. It is calculated based on admission data of medical history, EKG, age, cardiovascular risk factors and troponin levels. The HEART score was created specifically to identify ED patients presenting with undifferentiated chest pain who were at low risk as well as patients at high risk of short-term MACE occurrence. HEART score has been widely reported to outperform the TIMI and the GRACE scores. Several scientific societies are encouraging the use of HEART score, for evaluating patients with chest pain suggestive of ACS in the ED. The goal of our investigation is to validate HEART score as a prognostication tool among ED patients with chest pain in teaching hospitals in Tunisia.

Conditions

Coronary Disease; Coronary Syndrome; Risk Factor, Cardiovascular; Major Adverse Cardiovascular Events

Outcome Measures

Primary Outcomes (1)

• Mace

  Rate of MACE occurence including all-cause mortality, non-fatal myocardial infarction (MI), and coronary revascularisation within 30 days.

  30 days

Eligibility Criteria

• Age: 30 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients aged over 30 years admitted to the ED with typical chest pain with an EKG not showing STEMI.

You may qualify if:

• Any adult aged older than 30 years.
• Chief complaint of ''chest pain'', ''chest tightness'', or ''chest pressure''.

You may not qualify if:

• Shortness of breath without chest pain
• ST elevation myocardial infarction (STEMI)
• Patients lost to follow up
• Patients with obvious diagnosis made immediately after initial medical evaluation

Sponsors & Collaborators

• University of Monastir: lead

Study Sites (3)

Sahloul University Hospital

Hammam Sousse, Sousse Governorate, 4011, Tunisia

Location

Emergency department of university hospital Fattouma Bourguiba of Monastir Monastir, Monastir Tunisia

Monastir, 5000, Tunisia

Location

Emergency department of university hospital Farhad Hached, Sousse

Sousse, 4000, Tunisia

Location

MeSH Terms

Conditions

Coronary Disease; Angina, Unstable

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Angina Pectoris; Chest Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Nouira semir, MD

  CHU fattouma Bourguiba Monastir

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professeur

Study Record Dates

• First Submitted: September 29, 2020
• First Posted: October 8, 2020
• Study Start: January 1, 2015
• Primary Completion: April 1, 2017
• Study Completion: August 1, 2018
• Last Updated: May 6, 2021

Record last verified: 2021-04

Locations

TU (3)