Chest Pain Clinical Trial
Official title:
Performance of a New Risk Score (SVEAT Index) to Identify Low-risk Patients Presenting to Emergency Department With Acute Chest Pain
This is a prospective, observational study to assess the efficacy of the newly developed
SVEAT scoring system in identifying low-risk patients who may be eligible for early
discharge. Various elements of clinical information including Symptoms, Vascular history,
EKG, Age and Troponin values will be checked and entered on the scoring form to calculate the
SVEAT risk score. Additionally, HEART score and TIMI risk score will be calculated for the
same subjects.
The primary aim is to assess the positive and negative predictive values for the SVEAT index
for cardiovascular events and compare it to the HEART and TIMI Scores.
This is a prospective, observational study in patients presenting to the emergency department
or admitted to clinical decision unit at Renown Regional Medical Center with a primary
complaint of chest pain in a period of 12 months.
All patient >24 years will be recruited. Exclusion criteria include patients with clear-cut
acute ST-segment elevation myocardial infarction, traumatic non-cardiac chest pain,
life-expectancy less than 90 days, hemodynamic instability or inability to provide informed
consent. Data and scores based on commonly known TIMI* risk score, HEART score and a newly
developed SVEAT index ( Symptoms, Vascular disease, EKG, Age, Troponin) will be obtained by
primary investigator trained physicians or advanced nurse practitioners as earliest as
possible after their initial presentation. The care of the patients will be left to the
discretion of the treating physician.
The outcome of each patient will be determined by either chart review, telephone contact or
office visit as appropriate in 30 days post presentation. The sensitivity, specificity,
positive and negative predictive value of SVEAT index will be calculated using standard
statistical analysis. The receiver operating characteristic (ROC) curves of SVEAT index, TIMI
risk score and HEART score will be generated and compared using commercially available
software. P value of 0.05 or less will be considered statistically significant difference.
The primary hypothesis of the study is that scoring systems that better incorporate useful
clinical information such as the SVEAT score may improve our ability to accurately identify
low-risk acute chest pain patients presenting to the ED.
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