Chest Pain Clinical Trial
Official title:
Cardiogoniometry Zur Früherkennung Akuter Myokardischämien Bei ACS-Symptomatik
Aims of the study:
Patients in a Chest Pain Unit (CPU) are examined to clarify if the cause of pain is cardiac
or not. To identify patients with ST-elevation and other electrocardiogram (ECG)
modifications a normal 12-lead ECG is used. The diagnosis non-st-elevation myocardial
infarction is determined with the help of the ischemic marker Troponin. However, Troponin
levels are elevated earliest 3 to 4 hours after the ischemic event, so that a negative
Troponin result at the time of hospital admission is insufficient. Thus the guidelines of
the German Society of Cardiology demand a second measurement after 6 to 12 hours. In rare
cases false positive Troponin levels have been reported (e.g. in patients with renal
insufficiency).
The aim of this study is to determine if in the early phase of diagnostic assessment
cardiogoniometry can improve differentiation between patients with cardiac (ischemic)
emergency and patients with non-cardiac (non-ischemic) cause of pain. Furthermore it will be
evaluated if cardiogoniometry is capable to diagnose patients with non-ST-elevation
myocardial infarction (NSTEMI) to the same extent as Troponin. This could avoid time loss
until a possibly necessary catheter intervention ("fast track").
To clarify these questions the result of the cardiogoniometry will be compared with the
leading diagnosis of the Chest Pain Unit, the diagnosis at hospital discharge as well as
with the angiographic findings (as a gold standard). Therefore the performance of cardiac
catheterization within 72 hours after start of symptoms is a mandatory inclusion criterion.
The cardiogoniometry vectorcardiography is a procedure that allows a stress-free and non-invasive diagnosis of myocardial ischemia: five thoracic electrodes as well as the heart flow in orthogonal summation vectors are recorded by a computer-assisted method in three dimensions. ;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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