Abstract
In the Emergency Department, patients with suspected myocardial infarction can be risk stratified using the HEART pathway, which has recently been amended for prehospital use and modified for the incorporation of a high-sensitivity cardiac troponin test. In a prospective analysis, the performance of both HEART pathways in the prehospital setting, with a high-sensitivity cardiac troponin test using 3 different thresholds, was evaluated for major adverse cardiac events at 30 days. We found that both low-risk HEART pathways, when using the most conservative cardiac troponin thresholds, approached but did not reach accepted rule-out performance in the Emergency Department.
| Original language | English |
|---|---|
| Pages (from-to) | 182-187 |
| Number of pages | 6 |
| Journal | American Heart Journal |
| Volume | 271 |
| Early online date | 23 Apr 2024 |
| DOIs | |
| Publication status | Published - 1 May 2024 |
Bibliographical note
This study was approved by the National Ethics Committee (REC 14/NS/1037), registered in the Research Registry (UIN 2671), and was conducted in accordance with the Declaration of Helsinki.CRediT authorship contribution statement
Jamie G. Cooper: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Software, Resources, Project administration, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization. James Ferguson: Writing – review & editing, Supervision, Resources, Investigation, Funding acquisition, Data curation, Conceptualization. Lorna A. Donaldson: Writing – review & editing, Supervision, Software, Resources, Project administration, Methodology, Investigation, Data curation. Kim M.M. Black: Writing – review & editing, Supervision, Software, Resources, Investigation, Funding acquisition, Data curation, Conceptualization. Kate J. Livock: Writing – review & editing, Supervision, Software, Resources, Project administration, Funding acquisition. Judith L. Horrill: Writing – review & editing, Software, Resources, Project administration, Investigation. Elaine M. Davidson: Writing – review & editing, Validation, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization. Neil W. Scott: Writing – review & editing, Writing – original draft, Supervision, Methodology, Investigation, Funding acquisition, Formal analysis, Conceptualization. Amanda J. Lee: Writing – review & editing, Writing – original draft, Supervision, Methodology, Formal analysis. Takeshi Fujisawa: Writing – review & editing, Validation, Resources, Methodology, Investigation, Data curation. Kuan Ken Lee: Writing – review & editing, Validation, Formal analysis, Data curation. Atul Anand: Writing – review & editing, Validation, Formal analysis, Data curation. Anoop S.V. Shah: Writing – review & editing, Validation, Formal analysis, Data curation. Nicholas L. Mills: Writing – review & editing, Writing – original draft, Validation, Supervision, Methodology, Investigation, Formal analysis.
Data Availability Statement
No data availability statement.Funding
We would like to acknowledge the invaluable contribution of all the participating SAS paramedics and technicians as well as the support of the regional and national SAS managerial structures. We are also thankful for the involvement of numerous medical, nursing, reception and portering staff within the Emergency Department of Aberdeen Royal Infirmary and the assistance of Gary Robinson, Chaloner Chute and Susan Scotland from the DHI. The study was supported financially by the Digital Health & Care Institute (DHI) (Reference DHI/MCADAM), Scotland and by the NHS Grampian Endowment Fund (Grant Number N0042903) and the University of Aberdeen contributed to the design and administration of the study. The funders had no role in study design, data collection, or interpretation, or the writing of the report. JGC was supported by a National Research Scotland Clinical Research Fellowship. KL and NLM are supported by the British Heart Foundation through a Clinical Research Training Fellowship (FS/18/25/33454) and a Chair Award, Programme Grant, and Research Excellence Award (CH/F/21/90010, RG/20/10/34966, RE/18/5/34216), respectively.
| Funders | Funder number |
|---|---|
| British Heart Foundation | RG/20/10/34966, CH/F/21/90010, FS/18/25/33454, RE/18/5/34216 |
| NHS Grampian Endowment Fund | N0042903 |
| Digital Health & Care Institute | DHI/MCADAM |