Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT04580017 |
| Other study ID # |
HEART score |
| Secondary ID |
|
| Status |
Completed |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
January 2015 |
| Est. completion date |
August 2018 |
Study information
| Verified date |
April 2021 |
| Source |
University of Monastir |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial 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.
Description:
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. Obviously, medical history, clinical examination, and laboratory
values may help to identify patients with true ACS. None are sufficiently accurate to be used
independently. Thus, about 5% of ACS patients are inappropriately discharged annually.
Therefore, there is a global tendency for ED physician to overinvestigate chest pain patients
with further, often more invasive testing, even in low-risk patients. This kind of practice
leads to resource overutilization and a huge health costs waste contrasting with no outcomes
improvement.
For many years, physicians were searching tools, ranging from specific diagnostic tests to
entire strategies of evaluation, to appropriately risk stratify patients with chest pain in
order to simultaneously prevent major adverse cardiac events and reduce unnecessary testing
and hospitalisations. Based on the principal that a prompt quick and accurate identification
of patients who are at high and low risk of developing major adverse cardiac events is
paramount, and in order to optimally allocate ED and hospital resources, many bioclinical
scores have been developed. One of the most known risk scores is TIMI score, which was
originally derived and validated in a population of in-patients with unstable angina and non
ST elevation myocardial infarction (NSTEMI). Its main performance is to predict early
occurrence of major cardiovascular events (MACE). However, TIMI score like many other
specific scores gave conflicting results when applied on chest pain patients in the ED. 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. A recent systematic review comprehensively compared
the leading clinical prediction rules for chest pain, including the TIMI, the HEART, and the
GRACE scores. Among the three risk stratification tools, the HEART score was found to be the
most useful for managing patients with undifferentiated chest pain who present to the ED
because it is simple, easy, and quick to use and it also has been validated in several
studies conducted in the ED. Additional studies providing further worldwide data about the
validation of this risk score will empower emergency physicians' decision making when relying
on this score in ruling in or ruling out their chest pain patients. 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.
