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Prehospital study to the use of HEART-score in chest pain patients


- candidate number27728
- NTR NumberNTR6606
- ISRCTNISRCTN no longer applicable
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR8-aug-2017
- Secondary IDsNL62976.101.17 toetsingonline
- Public TitlePrehospital study to the use of HEART-score in chest pain patients
- Scientific TitlePrehospital Observational study Rotterdam Troponin. observational comparative study to the use of HEART score in the prehospital phase
- ACRONYMPORT
- hypothesisFeasibility and reliability of prehospital triage in patients with thoracic complaints/pain appropriate to a suspicious ACS
- Healt Condition(s) or Problem(s) studiedChest pain, Acute coronary syndrome (ACS)
- Inclusion criteriaAll patients over the age of 18 who, after assessment of the ambulance nurse, need to be transported to the hospital with complaints appropriate to a suspicious ACS
- older than 18 years
- legally capable to give consent
-thoracic pain or complaints appropriate to a suspicious ACS
-Understand the Dutch language sufficiently
-signed informed consent
- transported to Maasstad or Ikazia hospital
- Exclusion criteria-legally incapable to give consent or comatose
- incapable to understand the dutch language
- STEMI on EKG
- Missing EKG
- Clear other cause of thoracic pain/complaints (pneumonia, aorta dissection, trauma, pneumothorax etc.)
- impossibility iv venflon
- mec approval receivedno
- multicenter trialno
- randomisedno
- groupParallel
- TypeSingle arm
- Studytypeobservational
- planned startdate 1-okt-2017
- planned closingdate31-mrt-2017
- Target number of participants600
- Interventionsblood sample (Troponin) earlier in the proces
- Primary outcomeMace after 30 days, 3 months and 1 year
Mace is defined as acute myocardial infraction, CAG, PCI, CABG or death
- Secondary outcomefeasibility of HEART-score use in prehospital phase
- Timepointsin prehospital phase HEART-score
Arrival hospital HEART score
- Trial web site-
- statusplanned
- CONTACT FOR PUBLIC QUERIESStudent Nurse practitioner N.W.P.L. van der Waarden
- CONTACT for SCIENTIFIC QUERIESStudent Nurse practitioner N.W.P.L. van der Waarden
- Sponsor/Initiator AmbulanceZorg Rotterdam Rijnmond
- Funding
(Source(s) of Monetary or Material Support)
AmbulanceZorg Rotterdam Rijnmond
- Publications
- Brief summaryIt seems obvious that a significant part of all ambulances deployments which presents themselves as thoracic complaints may be of a cardiologic nature. Due to the limited prehospital diagnostic possibilities of these category patients (who present themselves with thoracic pain associated with acute coronary syndrome (ACS), it is not possible to confirm or exclude an ACS in this first phase. The result is that this patients can be transported to a hospital which is not able to provide the optimal care (non­ intervention versus intervention center).
The prehospital confirmation or exclusion of an ACS can positively contribute to decision­making and the quality of care. Based on risk stratification using the HEART score, the ambulancenurse can determine the risk profile of the patient and rule out or diagnose of ACS. The HEART score consists of five components, History, EKG, Age, Risk Factors and Troponin. Each part is scored and a total score is generated. The HEART score is a validated risk assessment instrument. Determining a troponin is an important part of the standard care for patients with ACS symptoms.
With the implementation of the prehospital HEART score, the Troponin is done in the ambulance or at the patients home. This is expected not only to improve patient safety, but can also have a positive impact on costs and workload.
For this study only feasibility en reliability of the use of HEART­score is tested in de prehospital phase. one blood sample is taking for troponin, but is blinded on de point of care testing voor de nurses. The treatment is usual care conform LPA 8.1. The blood sample for troponin goes to the laboratorium from the hospital for usual troponin assessment.

Feasibility and reliability of prehospital triage in patients with thoracic complaints/pain appropriate to a suspicious ACS in The Netherlands
- Main changes (audit trail)
- RECORD8-aug-2017 - 13-aug-2017


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