EMPACT is the first attempt to comprehensively evaluate the current emergency care of acute chest pain from a regional representative sample in China.Findings will allow new opportunities to facilitate the clinical quality improvements and ultimately reduce the mortality and health care burden in patients with acute chest pain. It also will help to establish a regional network and database for further research and performance improvement.

Inclusion criteria

1. Eighteen years and older
2. Presenting to the ED
3. With acute chest pain or suspected ACS
4. Symptoms occurring within 24 hours
5. Informed consent from patient or next of kin

Exclusion criteria

1. Chest pain caused by trauma
2. Persisting or recurrent chest pain caused by rheumatic diseases or cancer
3. Transferred from another grade II or grade III hospital
4. Presenting to the ED again within 30 days after initial enrollment

We used a stratified random sampling design to generate a Shandong province representative sample of hospitals. Twenty two hospitals were randomly selected including 12 rural hospitals, 6 grade II and 4 grade III urban hospitals. One grade II-urban hospital refused to participate. As a coordinating center, Qilu Hospital of Shandong University participated in the study without being sampled. Finally, 22 hospitals were included.

A total of more than 10000 patients were anticipated to be consecutively enrolled from the participating hospitals over the course of the 12-month program. The beginning dates of enrollment in 22 centers were distributed from January, 2016 to September 2016.