ACCESS V0.10 28/07/2014
Research type
Research Study
Full title
Ambulance Cardiac Chest Pain Evaluation Study in Scotland (ACCESS)
IRAS ID
154563
Contact name
Jamie G. Cooper
Contact email
Sponsor organisation
NHS Grampian
Duration of Study in the UK
1 years, 6 months, 1 days
Research summary
Cardiac chest pain is a common reason for a 999 ambulance call. An electrocardiogram (ECG) performed by paramedics pre-hospital can often diagnose patients with a major heart attack (due to a blocked artery) and allow prompt treatment, either with a clot busting drug in the ambulance, or via direct access to facilities to open the arteries on hospital arrival.
Many patients who have had heart damage will have ECGs that are non diagnostic and much recent and current work has focused on risk stratification of this population, particularly to identify those at high risk, requiring rigorous investigation and those at low risk (and perhaps suitable for early discharge)
Risk stratification involves a combination of the history, clinical presentation, risk factors for heart disease, ECG findings and a blood test for heart muscle damage (called cardiac troponin or cTNI). In order to standardise this process some scores have been developed, one of which is called the HEART score.
To our knowledge, such scores have never been robustly tested in the pre-hospital environment. Other than the blood test, the information required to complete the HEART score is routinely collected by paramedics. If use of the HEART score (including the blood test) pre-hospital was feasible and accurate it may lead to earlier identification and treatment of high risk patients, alter patient pathways and, in rural environments, perhaps identify a population suitable for care closer to home dependent on facilities.
Primary Objective
To ascertain the ability of the HEART score performed by ambulance personnel with access to a point of care (POC) cardiac troponin (cTNI) to predict risk of a Major Adverse Cardiac Event (MACE) at 30 days.
REC name
North of Scotland Research Ethics Committee 2
REC reference
14/NS/1037
Date of REC Opinion
29 Sep 2014
REC opinion
Further Information Favourable Opinion