Risk stratification in suspected acute coronary syndrome
Research type
Research Study
Full title
A comparison of risk scores in consecutive, unselected chest pain presentations with suspected acute coronary syndrome in the era of high sensitive Troponin
IRAS ID
66661
Contact name
Aleem Khand
Contact email
Sponsor organisation
Aintree University Hospital
Duration of Study in the UK
0 years, 2 months, 1 days
Research summary
Chest pain results in up to 9.4% of presentations to emergency departments in the UK and up to 27.4% of hospital admissions. The morbidity, mortality and economic costs associated with this constitute a significant burden on the National Health Service (NHS).
Distinguishing patients with serious and potentially life-threatening causes of chest pain from those with ‘benign’ causes is important but often difficult. There are numerous risk scores available for estimating risk in patients with heart attacks but these have not been widely applied or tested in those presenting to accident and emergency (A&E) department with chest pain when the diagnosis of a heart attack has not yet been established but is suspected. These tools were based on older heart marker (Troponin) blood tests. Troponin is a protein released in the blood if there is any damage to the heart muscle. The advent of a newer heart marker blood test (high-sensitivity (HS) Troponin T) has led to improved earlier detection of heart attacks and improved the sensitivity of the test (more heart attacks being identified).
The aim of this observational study is twofold. Firstly to determine which of the three established methods of risk stratifying patients (predicting risk in suspected heart attacks) namely, the Global Registry of Acute Coronary Events (GRACE), Thrombolysis in Myocardial Infarction (TIMI) and HEART score in the era of high sensitivity troponins performs best. Secondly this study aims to determine whether the results of a high sensitivity troponin and electrocardiogram (ECG) on admission could be used alone to direct care (expedite early and safe discharge in those whose electrocardiogram (electrical tracing of the heart) and where troponin is within normal range).
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
15/NW/0629
Date of REC Opinion
27 Aug 2015
REC opinion
Favourable Opinion